Resting energy expenditure in non-ventilated, non-sedated patients recovering from serious traumatic brain injury: Comparison of prediction equations with indirect calorimetry values

McEvoy, Claire T.; Cran, G. W.; Cooke, Stephen

doi:10.1016/j.clnu.2009.04.009

Cited by 28 publications

(33 citation statements)

References 24 publications

(47 reference statements)

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“…Reaching steady state has shown to be challenging in some populations such as postmenopausal women 18 and patients with traumatic brain injury. 34 Our results indicate that valid steady-state data can be obtained from SCI patients, at the bedside, without any changes to usual standard protocols. Similar to published recommendations for healthy individuals, 17 a reduced test duration of 10 minutes may be plausible for SCI patients given the proportion who reached steady state within this timeframe.…”

Section: Staff Acceptabilitymentioning

confidence: 57%

Feasibility and Acceptability of Implementing Indirect Calorimetry Into Routine Clinical Care of Patients With Spinal Cord Injury

Nevin

Mayr

Atresh

et al. 2016

Topics in Spinal Cord Injury Rehabilitation

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Background:In the absence of reliable predictive equations, indirect calorimetry (IC) remains the gold standard for assessing energy requirements after spinal cord injury (SCI), but it is typically confined to a research setting. The purpose of this study is to assess the feasibility and acceptability of implementing IC into routine clinical care in an Australian SCI rehabilitation facility. Methods: Bedside IC (canopy hood) was performed, and patients completed an IC acceptability questionnaire (open-ended; yes/no; 5-point Likert scale). Fasted resting energy expenditure (REE) steady-state criteria were applied to assess data quality, and adherence to a test ≥20 minutes was recorded. Staff were surveyed to assess impact of IC on usual care. Results: Of 35 eligible patients, 9 declined (7 reported claustrophobia). One patient could not be tested before discharge and 25 underwent IC (84% male, injury level C2-L2, AIS A-D). Anxiety prevented one patient from completing IC, while another failed to fast. The remaining 23 patients achieved a steady-state REE (≥5 consecutive minutes with ≤10% coefficient of variation for VO 2 and VCO 2 ). Test-retest (n = 5) showed <10% variation in REE. Patients deemed the procedure acceptable, with 88% reporting a willingness to repeat IC. Eighty percent of patients and 90% of staff agreed it was acceptable for IC to be integrated into usual care. Conclusion: This study found that IC is a feasible and acceptable addition to the routine clinical care of patients recovering from SCI and may serve to improve accuracy of nutrition interventions for this patient population.

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Section: Staff Acceptabilitymentioning

confidence: 57%

Feasibility and Acceptability of Implementing Indirect Calorimetry Into Routine Clinical Care of Patients With Spinal Cord Injury

Nevin

Mayr

Atresh

et al. 2016

Topics in Spinal Cord Injury Rehabilitation

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“…35 The REE of an individual with SCI is thought to be raised in the acute phase of injury as the body goes through spinal shock 1 and then decrease to below energy needs before injury (as measured by matched controls). 12,26,36,37 This review found only two studies that measured REE within the first 6 months after SCI (mean REE = 1324-1469 kcal per day), 8,30 and it was unable to capture the hypothesised increased energy needs in the 'acute phase,' compared with the decreased energy needs in the 'chronic phase' of SCI.…”

Section: Discussionmentioning

confidence: 99%

Investigation of measured and predicted resting energy needs in adults after spinal cord injury: a systematic review

et al. 2015

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Background: Accurate estimation of energy needs is vital for effective nutritional management of individuals with spinal cord injury (SCI). Inappropriate energy prescription after SCI can compound the rates of malnutrition or obesity, increase the risk of complications and negatively influence outcomes. Energy requirements following SCI are not well understood, and there is currently no universally accepted method of estimating energy needs in clinical practice. Study design: This is a systematic literature review. Objectives: The objectives of this study were to investigate and compare the measured resting energy needs of adults with SCI across different phases of rehabilitation, and to identify appropriate energy prediction equations for use in SCI. Setting: This study was conducted in Australia. Methods: MEDLINE, EMBASE and CENTRAL databases were searched for studies published between 1975 and April 2015, identifying 298 articles. Full articles in English language of adults with SCI who were fasted for a minimum of 8 hours before undergoing indirect calorimetry to measure resting energy expenditure (REE) for at least 20 min were selected. On the basis of the inclusion criteria, 18 articles remained for data extraction. One author extracted information from all articles, and inter-rater reliability was tested in five articles. Results: REE across three phases of injury was assessed: acute, sub-acute and chronic. Few studies (n = 2) have investigated REE in the acute and sub-acute injury stages of SCI recovery. The factors influencing chronic energy needs in SCI patient populations are many and varied, and a valid predictive equation for use in SCI remains elusive. SCI is initially associated with catabolic conditions of trauma such as spinal shock and patients may be at risk of weight loss, malnutrition and pressure injuries. 1 In the long term, SCI results in marked body composition changes, specifically muscle atrophy below the level of injury and higher relative fat mass compared with people without SCI, 1-3 which may contribute to decreases in resting energy expenditure (REE). In an environment of reduced mobility, energy needs are further reduced, and there is an increased risk of weight gain and obesity-related chronic diseases. 4,5 To prescribe an appropriate daily energy intake, an individual's total daily energy expenditure (TDEE) must be determined. An individual's TDEE comprises three components, two of which may be considerably affected by SCI. Basal metabolic rate (BMR) is the minimum energy required for the basal processes of life, and it contributes the majority (~70%) of TDEE in a healthy person. 6 In the clinical literature, the term BMR is often used interchangeably with REE, and for the purpose of this review REE is defined as the energy expended in an awake, alert individual in a rested position following

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“…Isı üretilmesi ve kaybının ölçülmesi, enerji tüketiminin ölçülmesi anlamına gelir (direk kalorimetri). Oksijen tüketiminin ve CO 2 üretiminin ölçülmesi ile ısı üretiminin ölçülmesi indirekkalorimetri yöntemidir (15,23,24). GİS: gastrointestinal sistemi; GRV: gastrik rezidüel volüm rezervinin izlemi önemlidir.…”

Section: D) Biyoelektrik Empedans Spektroskopiunclassified

Yoğun Bakim Hastalarinda Enteral Ve Parenteral Nütrisyon

Çekmen¹,

Di̇kmen²

2014

Toraks Cer Bult

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Malnutrition is a major problem in hospitalized patients during admission and the hospital stay. The morbidity and mortality rates would be decreased once the malnutrition is diagnosed and treated. The patients must be monitored to evaluate the efficacy and complications of the nutritional therapy.Key words: Intensive Care Medicine, Enteral and Parenteral Nutrition, Monitorization, Malnutrition ÖzetHastanede yatan hastalar içinde hem başvuru sırasında hem de yatışta malnütrisyon önemli bir sorundur. Malnütrisyonun tanınması ve uygun beslenme tedavisi başlanması, hastaların morbidite ve mortalitesini azaltmaktadır.Beslenme tedavisinin etkinliğinin ve olası komplikasyonların değerlendirilmesi için hastaların izlemleri gereklidir.

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Resting energy expenditure in non-ventilated, non-sedated patients recovering from serious traumatic brain injury: Comparison of prediction equations with indirect calorimetry values

Cited by 28 publications

References 24 publications

Feasibility and Acceptability of Implementing Indirect Calorimetry Into Routine Clinical Care of Patients With Spinal Cord Injury

Feasibility and Acceptability of Implementing Indirect Calorimetry Into Routine Clinical Care of Patients With Spinal Cord Injury

Investigation of measured and predicted resting energy needs in adults after spinal cord injury: a systematic review

Yoğun Bakim Hastalarinda Enteral Ve Parenteral Nütrisyon

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