Mechanical ventilation mode (volume × pressure) does not change the variables obtained by indirect calorimetry in critically ill patients

Clapis, Franciele C. Meireles; Auxiliadora‐Martins, Maria; Japúr, Camila Cremonezi; Martins‐Filho, Olindo Assis; Évora, Paulo Roberto Barbosa; Basile-Filho, Aníbal

doi:10.1016/j.jcrc.2009.11.010

Cited by 17 publications

(8 citation statements)

References 27 publications

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“…Finally, the ventilation mode was not recorded at the time of assessment, because this parameter does not affect indirect calorimetry variables in critically ill patients. 33 …”

Section: Discussionmentioning

confidence: 99%

Harris-Benedict Equation and Resting Energy Expenditure Estimates in Critically Ill Ventilator Patients

Picolo¹,

Lago²,

Menegueti³

et al. 2015

American Journal of Critical Care

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“…Finally, the ventilation mode was not recorded at the time of assessment, because this parameter does not affect indirect calorimetry variables in critically ill patients. 33 …”

Section: Discussionmentioning

confidence: 99%

Harris-Benedict Equation and Resting Energy Expenditure Estimates in Critically Ill Ventilator Patients

Picolo¹,

Lago²,

Menegueti³

et al. 2015

American Journal of Critical Care

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“…[75][76][77] The volume-controlled ventilator mode has been considered the ideal setting, because it results in less variation in minute ventilation (Ve), which alters gas balance. 77,78 Spontaneous breath settings such as CPAP cause instability and, therefore, may not appropriate for IC testing. 78 While often assumed that a control mode is the only ventilatory setting appropriate for an IC study, other settings may be considered as well.…”

mentioning

confidence: 99%

“…77,78 Spontaneous breath settings such as CPAP cause instability and, therefore, may not appropriate for IC testing. 78 While often assumed that a control mode is the only ventilatory setting appropriate for an IC study, other settings may be considered as well. A mixed-mode setting such as synchronized intermittent mandatory ventilation (SIMV) may be considered for IC testing, although used with caution.…”

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confidence: 99%

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Best Practices for Determining Resting Energy Expenditure in Critically Ill Adults

Schlein

Coulter

2013

Nut in Clin Prac

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Indirect calorimetry (IC) is the gold standard for measuring resting energy expenditure (REE) in the critically ill patient. The use of predictive equations to develop nutrition regimens can be problematic in the critical care setting, because the effects that disease, injury, and stress have on REE are often varied and unpredictable. IC testing ensures that the specific conditions of the critically ill patient are taken into account, thereby preventing potential complications from over- and underfeeding. The clinical indications for and appropriate applications of IC testing are discussed. In addition, 3 case studies are presented that highlight the application of IC. The clinician can face numerous obstacles in implementing IC testing, including lack of equipment, staff shortages, and lack of knowledge regarding application and interpretation of the IC study. Recommendations for addressing these challenges are discussed. In addition, guidelines on ordering and interpreting the IC study are provided. Best practices for predictive equations in critically and acutely ill patients are also presented, since IC testing is not feasible in certain situations. Given the importance of predicting REE in the critically ill patient, it is paramount that more healthcare professionals incorporate IC testing into practice. A multidisciplinary approach is helpful in developing a well-established clinical practice. Nutrition support clinicians can promote optimal nutrition management by being well-informed and able to provide evidence-based recommendations for the use of IC.

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“…Researchers have studied oxygen consumption (VO 2 ) and energy expenditure (EE) in mechanically ventilated patients. It was assessed how the variables VO 2 and EE change upon alterations in mechanical ventilation parameters and modes [ 12 , 13 ], weaning from mechanical ventilation [ 14 , 15 ], physiotherapy [ 16 ], and nutritional therapy [ 17-19 ]. Therefore, VO 2 and EE constitute gold standard in this field.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Energy Expenditure and Oxygen Consumption of Spontaneous Breathing Trial Conducted With and Without Automatic Tube Compensation

et al. 2015

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BackgroundWeaning from mechanical ventilation is defined as the process of release of ventilatory support and how the evaluation of this phase is conducted in the spontaneous breathing trial (SBT). One of the most used modes of SBT is the continuous positive airway pressure (CPAP), which applies a continuous positive pressure in both inspiration and expiration. However, together with the mechanical ventilation modes, the automatic tube compensation (ATC) can be used, which compensates the resistance imposed by the endotracheal tube. The objective of this study was to compare oxygen consumption (VO2) and energy expenditure (EE) during SBT conducted with and without ATC.MethodsThe study was prospective, randomized and crossover. Forty mechanically ventilated patients were admitted to an intensive care unit of a university tertiary hospital. The participants were randomly allocated in group 1, in which SBT was initiated with CPAP and ATC, followed by CPAP without ATC or in group 2, in which SBT was initiated with CPAP without ATC, followed by CPAP with ATC. Indirect calorimetry helped to measure VO2 and EE during SBT.ResultsThe differences between VO2 and EE obtained during SBT with ATC and without ATC were -1.6 mL/kg/min (95% CI: -4.36 - 1.07) and 5.4 kcal/day (95% CI: -21.67 - 10.79), respectively.ConclusionsWe concluded that VO2 and EE obtained during SBT with and without ATC were not different.

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Mechanical ventilation mode (volume × pressure) does not change the variables obtained by indirect calorimetry in critically ill patients

Abstract: Ventilators and ventilation modes do not influence the IC measurements. The observed changes have no clinical effects and are reversible, provided that increased Vm is maintained for no longer than 45 minutes.

Cited by 17 publications

References 27 publications

Harris-Benedict Equation and Resting Energy Expenditure Estimates in Critically Ill Ventilator Patients

Harris-Benedict Equation and Resting Energy Expenditure Estimates in Critically Ill Ventilator Patients

Best Practices for Determining Resting Energy Expenditure in Critically Ill Adults

Comparison of Energy Expenditure and Oxygen Consumption of Spontaneous Breathing Trial Conducted With and Without Automatic Tube Compensation

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