Measured versus estimated energy expenditure in mechanically ventilated critically iII patients

Cheng, Chun-Wen; Chen, C.-H.; Wong, Y.; Lee, B.-J.; Kan, Mee-Nin; Huang, Yann-Chang

doi:10.1054/clnu.2002.0526

Cited by 49 publications

(40 citation statements)

References 39 publications

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“…Cheng et al (3) analyzed five equations in 46 patients under mechanical ventilation, and results disclosed that energy expenditure may be estimated in the majority of critically ill patients using the Harris-Benedict, Kleiber and Liu formulas, as long as a factor of injury is used. Faisy et al, (16) in the following year, compared energy expenditure measured by IC and estimated by the HarrisBenedict equation observing a 25% higher expenditure in IC, however when using a correlation factor for injury this difference was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…All patients were submitted to the same procedure. (3,12) Data analysis Data were expressed in mean ± standard deviation, with a significance level of p<0.05. Differences between values found for energy expenditure measured by indirect calorimetry and estimated by the predictive Ireton-Jones formula were calculated using the Student's t test for paired samples.…”

Section: Data Collectionmentioning

confidence: 99%

“…(2,3) One alternative to reduce risks of an erroneous estimate of energy expenditure in critically ill patients is indirect calorimetry (IC). It is considered to be safe, non-invasive, precise and almost free of complications and classified as a reference method for determination of energy expenditure.…”

Section: Introductionmentioning

confidence: 99%

“…(7) Although it has been devised for critically ill patients, authors have shown that the IJ formula, as well as that of Harris Benedict, still intensely used by nutritional therapy profession may also present errors in relation to the estimate of energy expenditure. (3) Energy requirements are affected by various factors not included in the predicting equations, such as infection, sepsis, cardiac surgery, metabolic and nutritional status, sedation and analgesia, ventilation mode and others. (8) Equations that include more variables may provide a more precise result in the determination of energy expenditure.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Gasto energético em ventilação mecânica: existe concordância entre a equação de Ireton-Jones e a calorimetria indireta?

Santos¹,

Balbinotti²,

Marques³

et al. 2009

Rev. bras. ter. intensiva

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Section: Discussionmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Gasto energético em ventilação mecânica: existe concordância entre a equação de Ireton-Jones e a calorimetria indireta?

Santos¹,

Balbinotti²,

Marques³

et al. 2009

Rev. bras. ter. intensiva

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“…They noted that although EE on IC was 25% greater, the difference was not statistically significant when the injury factor was applied for adjustment. In another study conducted in the previous year, Cheng et al 66 analyzed the accuracy of five predictive equations to estimate the EE of 46 patients on mechanical ventilation, including the Harris-Benedict and Kleiber and Liu equations, noting that EE can be estimated in most critically ill patients by these equations, provided that an injury factor is used. The predictive equation of Harris-Benedict is one of the oldest and most used to date; however, it is not recommended in critically ill patients.…”

mentioning

confidence: 99%

Resting energy expenditure in critically ill patients: Evaluation methods and clinical applications

Sanches

Góes

Bufarah

et al. 2016

Rev. Assoc. Med. Bras.

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SancheS acS et al. 672rev assoC med bras 2016; 62(7):672-679 Patients on intensive care present systemic, metabolic, and hormonal alterations that may adversely affect their nutritional condition and lead to fast and important depletion of lean mass and malnutrition. Several factors and medical conditions can influence the energy expenditure (EE) of critically ill patients, such as age, gender, surgery, serious infections, medications, ventilation modality, and organ dysfunction. Clinical conditions that can present with EE change include acute kidney injury, a complex disorder commonly seen in critically ill patients with manifestations that can range from minimum elevations in serum creatinine to renal failure requiring dialysis. The nutritional needs of this population are therefore complex, and determining the resting energy expenditure is essential to adjust the nutritional supply and to plan a proper diet, ensuring that energy requirements are met and avoiding complications associated with overfeeding and underfeeding. Several evaluation methods of EE in this population have been described, but all of them have limitations. Such methods include direct calorimetry, doubly labeled water, indirect calorimetry (IC), various predictive equations, and, more recently, the rule of thumb (kcal/kg of body weight). Currently, IC is considered the gold standard.Keywords: energy expenditure, critically ill patient, energy requirement, indirect calorimetry.iMportance of deterMining energy expenditure in critically ill patients Adequate supply of nutrients is an essential part of the overall treatment of critically ill patients and adjustment of nutritional requirements to the individual needs of patients is a matter crucial to their clinical evolution, because both situations, overfeeding and underfeeding, may contribute to high morbidity and mortality in this population. 1,2 In such a context, an adequate assessment of energy expenditure (EE) is the basis of effective nutritional planning. 3 Total energy expenditure (TEE) is defined as the energy required by the body daily, determined by adding the following components: basal energy expenditure (BEE), diet--induced thermogenesis (DIT) and physical activity (PA). 4 BEE reflects the energy requirements to maintain the intracellular environment and mechanical processes such as respiration and cardiac function, as well as thermoregulatory mechanisms responsible for regulating the body temperature. 5,6 It is considered the main component in TEE, contributing 60 to 75% of the daily energy requirement for most sedentary individuals and approximately 50% for the physically active. BEE must be measured in thermoneutral conditions (20ºC) in the absence of recent nutrient administration (12 to 14 hours of fasting), recent physical activity (at least 8 hours of sleep), and psychological stress, while the subject is fully awake, lying in silence, completely relaxed and breathing normally.The energy corresponding to the thermal effect of food refers to the expenditure caused by dige...

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Comparison of Energy Expenditure in Mechanically Ventilated Septic Shock Patients in Acute and Recovery Periods via Indirect Calorimetry

Israfilov

Kır

2021

J Parenter Enteral Nutr

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Background: Nutrition in intensive care units (ICUs) affects morbidity and mortality. We aimed to evaluate the energy expenditure of mechanically ventilated patients in early and late septic shock periods. Methods: This study retrospectively evaluated 28 mechanically ventilated septic shock patients (11 female/17 male) in a medical ICU. Indirect calorimetry (IC) measurement was performed for 24 hours during the acute and recovery periods of septic shock. The energy values calculated by Harris-Benedict equation (predicted resting energy expenditure [PREE]), measured by IC (measured resting energy expenditure [MREE]), and given to each patient were obtained in the acute and recovery periods. Results: The mean age was 67.46 ± 14.92 (36-91) years. The MREE was 2741.1 ± 706.3 kcal/d (38.61 ± 11.44 kcal/kg/d) and 2332.8 ± 426.6 kcal/d (32.65 ± 7.8 kcal/kg/d) in the acute and recovery periods, respectively, and showed significant differences (P = 0.001). The patients' energy intake was 1152.7 ± 207.1 kcal/d and 1542.7 ± 433.3 kcal/d in the acute and recovery periods, respectively. A significant difference existed between energy intake and MREE during the acute and recovery periods (P < 0.001 for both). Conclusion: Our findings showed that energy expenditure increases in septic shock. Significant differences existed between MREE, PREE, and energy intake, which were not correlated. The MREE was higher in the acute period. Despite the increasing energy requirement, the PREE and energy intake were well below MREE. For better clinical outcomes, each patient's energy expenditure must be closely monitored and evaluated using intermittent IC measurements.

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Measured versus estimated energy expenditure in mechanically ventilated critically iII patients

Cited by 49 publications

References 39 publications

Gasto energético em ventilação mecânica: existe concordância entre a equação de Ireton-Jones e a calorimetria indireta?

Gasto energético em ventilação mecânica: existe concordância entre a equação de Ireton-Jones e a calorimetria indireta?

Resting energy expenditure in critically ill patients: Evaluation methods and clinical applications

Comparison of Energy Expenditure in Mechanically Ventilated Septic Shock Patients in Acute and Recovery Periods via Indirect Calorimetry

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