Evaluation of stress factors and body weight adjustments currently used to estimate energy expenditure in hospitalized patients

Barak, Nir; Wall-Alonso, E; Sitrin,

doi:10.1177/0148607102026004231

Cited by 115 publications

(67 citation statements)

References 23 publications

(26 reference statements)

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“…The standard measurement that we used to compare with the MG did not include a 24-h urine collection to adjust energy expenditure for the incomplete oxidation of protein. Recent studies of short-term measurements of energy expenditure in patients do not commonly adjust for nitrogen excretion (Barak et al, 2002;Siervo et al, 2003), which produces a negligible error of 1-2% (Weir, 1949;Bursztein et al, 1989). So that measurements were directly comparable, REE was calculated from VO 2 measured by the MG without adjustment for nitrogen excretion.…”

Section: Discussionmentioning

confidence: 99%

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Clinical accuracy of the MedGem™ indirect calorimeter for measuring resting energy expenditure in cancer patients

et al. 2005

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Objective: To compare, in patients with cancer and in healthy subjects, measured resting energy expenditure (REE) from traditional indirect calorimetry to a new portable device (MedGemt) and predicted REE. Design: Cross-sectional clinical validation study. Setting: Private radiation oncology centre, Brisbane, Australia. Subjects: Cancer patients (n ¼ 18) and healthy subjects (n ¼ 17) aged 37-86 y, with body mass indices ranging from 18 to 42 kg/m 2 . Interventions: Oxygen consumption (VO 2 ) and REE were measured by VMax229 (VM) and MedGem (MG) indirect calorimeters in random order after a 12-h fast and 30-min rest. REE was also calculated from the MG without adjustment for nitrogen excretion (MGN) and estimated from Harris-Benedict prediction equations. Data were analysed using the Bland and Altman approach, based on a clinically acceptable difference between methods of 5%. Results: The mean bias (MGN-VM) was 10% and limits of agreement were -42 to 21% for cancer patients; mean bias À5% with limits of À45 to 35% for healthy subjects. Less than half of the cancer patients (n ¼ 7, 46.7%) and only a third (n ¼ 5, 33.3%) of healthy subjects had measured REE by MGN within clinically acceptable limits of VM. Predicted REE showed a mean bias (HB-VM) of À5% for cancer patients and 4% for healthy subjects, with limits of agreement of À30 to 20% and À27 to 34%, respectively. Conclusions: Limits of agreement for the MG and Harris Benedict equations compared to traditional indirect calorimetry were similar but wide, indicating poor clinical accuracy for determining the REE of individual cancer patients and healthy subjects.

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Section: Discussionmentioning

confidence: 99%

“…The adjusted weight was based on the recommendations from Glynn et al (1999) and Barak et al (2002):…”

Section: Prediction Of Reementioning

confidence: 99%

Clinical accuracy of the MedGem™ indirect calorimeter for measuring resting energy expenditure in cancer patients

et al. 2005

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“…According to guidelines on nutrition support in adults [56], patients with inadequate food intake for more than 5 days or BMI<18.5 or weight loss>10% in the last 3-6 months or weight loss >5% in the last 3-6 months and BMI<20 kg/m 2 received oral supplements or enteral nutrition (EN) if supplements were not sufficient to maintain an adequate oral intake. Patient's total energy requirements have been estimated using the Harris Benedict equation [24], with an activity factor of between 1.2 and 1.5 and a stress factor of 1.2 applied [5].…”

Section: Subjectsmentioning

confidence: 99%

Early nutritional intervention improves treatment tolerance and outcomes in head and neck cancer patients undergoing concurrent chemoradiotherapy

Paccagnella

Morello

Mosto

et al. 2009

Support Care Cancer

222

164

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“…Following our established protocol for nutritional assessment, energy requirements were calculated with the Harris-Benedict formula, using the actual weight in most patients except in case of obesity, when the adjusted weight was selected. We added a stress factor between 1.2 and 1.3 in most patients, following recommendations in hospitalized patients (14). Protein needs were calculated at 1.2 g of protein/kg weight/day.…”

Section: Methodsmentioning

confidence: 99%

A short nutritional intervention in a cohort of hematological inpatients improves energy and protein intake and stabilizes nutritional status

Villar-Taibo

Calleja-Fernández²,

Casariego³

et al. 2016

Nutr Hosp

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A short nutritional intervention in a cohort of hematological inpatients improves energy and protein intake and stabilizes nutritional status Una intervención nutricional en una cohorte de pacientes hospitalizados hematológicos mejora la ingesta calórico-proteica y estabiliza el estado nutricional ResumenIntroducción: las enfermedades oncohematológicas se asocian con una elevada prevalencia de malnutrición. Objetivo: nuestro objetivo es determinar si la detección y el tratamiento precoz de la malnutrición en los pacientes hematológicos hospitalizados pueden mejorar su ingesta, su estado nutricional y reducir la estancia hospitalaria. Métodos: estudio prospectivo de 2 años de duración realizado en una cohorte de pacientes hematológicos hospitalizados. El Malnutrition Screening Tool (MST) fue el método de cribado efectuado el primer día del ingreso. En los pacientes con un resultado positivo en el cribado se realizó una valoración nutricional completa y una intervención terapéutica cuando fue preciso, siguiendo la práctica clínica habitual. La valoración nutricional se repitió una semana después de la inicial. Resultados: se evaluaron 617 pacientes hematológicos (de los cuales el 37,8% tuvo un resultado positivo en el cribado). Tras una semana de ingreso, la mediana de ingesta aumentó del 80% al 90% de la dieta (p < 0,001), y se logró un incremento en el consumo de 407,36 (DE 679,37) Kcal y 17,58 (DE 31,97) g de proteínas. El número de pacientes que alcanzaron sus requerimientos calórico-proteicos aumentó (41,6% vs. 63,3%, p = 0,009) y los parámetros nutricionales permanecieron estables. La estancia hospitalaria tendió a ser menor en los pacientes que cubrían sus necesidades nutricionales (3,5 a 4,5 días menos). Conclusiones: la implantación de un método de cribado nutricional precoz y la realización de intervenciones nutricionales cortas consiguió mejorar la ingesta calórico-proteica, aumentando el porcentaje de pacientes que cubrían sus necesidades y evitando el deterioro del estado nutricional. AbstractIntroduction: Oncohematological diseases are associated with an important prevalence of malnutrition. Aim: Our aim is to determine if early recognition and treatment of malnourished hematological inpatients can improve their oral intake, nutritional status and reduce the length of hospital stay. Methods: Prospective 2-year study conducted in a cohort of hematology inpatients. Malnutrition Screening Tool (MST) was carried out on the fi rst day of admission. Patients with a positive screening were recruited to have a complete nutritional evaluation and intervention, following usual clinical practice. Nutritional evaluation was repeated after one week.Results: Six hundred and seventeen hematological patients were screened (37.8% with positive screening). After one week, median diet intake increased from 80% to 90% (p < 0.001), and an increase of 407.36 Kcal (SD 679.37) and 17.58 g of protein (SD 31.97) was also achieved. More patients reached their energy and protein requirements (41.6 vs.% 63.3%, p = 0.009) and nu...

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Evaluation of stress factors and body weight adjustments currently used to estimate energy expenditure in hospitalized patients

Cited by 115 publications

References 23 publications

Clinical accuracy of the MedGem™ indirect calorimeter for measuring resting energy expenditure in cancer patients

Clinical accuracy of the MedGem™ indirect calorimeter for measuring resting energy expenditure in cancer patients

Early nutritional intervention improves treatment tolerance and outcomes in head and neck cancer patients undergoing concurrent chemoradiotherapy

A short nutritional intervention in a cohort of hematological inpatients improves energy and protein intake and stabilizes nutritional status

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