Twenty-four hour energy expenditure in critically ill patients

Swinamer, Deanna L.; Phang, P. Terry; Jones, Richard L.; Grace, Michael; King, Elizabeth G.

doi:10.1097/00003246-198707000-00002

Cited by 114 publications

(42 citation statements)

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“…There is a wide variation in energy expenditure during a 24 h period and from day to day [82,83]. Although considered the 'gold standard' [56], indirect calorimetry remains firmly in the realm of research and is rarely performed in routine clinical care.…”

Section: Measurement Of Nutritional Statusmentioning

confidence: 99%

Military nutrition: maintaining health and rebuilding injured tissue

Hill

Fallowfield

Price

et al. 2011

Phil. Trans. R. Soc. B

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Food and nutrition are fundamental to military capability. Historical examples demonstrate that a failure to supply adequate nutrition to armies inevitably leads to disaster; however, innovative measures to overcome difficulties in feeding reap benefits, and save lives. In barracks, UK Armed Forces are currently fed according to the relatively new Pay As You Dine policy, which has attracted criticism from some quarters. The recently introduced Multi-Climate Ration has been developed specifically to deal with issues arising from Iraq and the current conflict in Afghanistan. Severely wounded military personnel are likely to lose a significant amount of their muscle mass, in spite of the best medical care. Nutritional support is unable to prevent this, but can ameliorate the effects of the catabolic process. Measuring and quantifying nutritional status during critical illness is difficult. A consensus is beginning to emerge from studies investigating the effects of nutritional interventions on how, what and when to feed patients with critical illness. The Ministry of Defence is currently undertaking research to address specific concerns related to nutrition as well as seeking to promote healthy eating in military personnel.

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Section: Measurement Of Nutritional Statusmentioning

confidence: 99%

Military nutrition: maintaining health and rebuilding injured tissue

Hill

Fallowfield

Price

et al. 2011

Phil. Trans. R. Soc. B

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“…However, the effect is transient, lasting £ 30 min post intervention, and therefore the contribution of such activities to TEE is likely to be small, i.e. 5-10% (Weissman et al 1986;Swinamer et al 1987). A literature review reveals a paucity of studies measuring the effects on physical activity (and thus energy expenditure) of abnormal neuromuscular function such as motor neurone disease, passive and active physiotherapy, the increased effort involved in moving injured and/or painful limbs and mechanical inefficiency, e.g.…”

Section: Prediction Equationsmentioning

confidence: 99%

Controversies in the determination of energy requirements

Weekes

2007

Proc. Nutr. Soc.

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To avoid any negative outcomes associated with under- or overfeeding it is essential to estimate nutrient requirements before commencing nutrition support. The energy requirements of an individual vary with current and past nutritional status, clinical condition, physical activity and the goals and likely duration of treatment. The evidence-base for prediction methods in current use, however, is poor and the equations are thus open to misinterpretation. In addition, most methods require an accurate measurement of current weight, which is problematic in some clinical situations. The estimation of energy requirements is so challenging in some conditions, e.g. critical illness, obesity and liver disease, that it is recommended that expenditure be measured on an individual basis by indirect calorimetry. Not only is this technique relatively expensive, but in the clinical setting there are several obstacles that may complicate, and thus affect the accuracy of, any such measurements. A review of relevant disease-specific literature may assist in the determination of energy requirements for some patient groups, but the energy requirements for a number of clinical conditions have yet to be established. Regardless of the method used, estimated energy requirements should be interpreted with care and only used as a starting point. Practitioners should regularly review the patient and reassess requirements to take account of any major changes in clinical condition, nutritional status, activity level and goals of treatment. There is a need for large randomised controlled trials that compare the effects of different levels of feeding on clinical outcomes in different disease states and care settings.

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“…Although it is the simplest solution, no manufacturer so far appears to have taken it up, despite the fact that at present the standard method of measuring energy expenditure in the free living individual is to measure carbon dioxide production and assume an RQ, or derive one from the food intake (Coward, 1988). Measurements of energy expenditure in ventilated patients with MOF have consistently shown a very wide range of values from 50 ± 200% of the basal value, predicted from age, height and weight, with an average of around 120 ± 140% Mann et al, 1985;Weissman et al, 1986;Swinamer et al, 1987). It has to be borne in mind that such measurements are markedly affected by the varying degrees of sedation and muscle relaxation required to facilitate arti®cial ventilation.…”

Section: Assessment Of Energy Requirementsmentioning

confidence: 99%

Limitations of nutrient intake. The effect of stressors: trauma, sepsis and multiple organ failure

1999

Eur J Clin Nutr

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Twenty-four hour energy expenditure in critically ill patients

Cited by 114 publications

References 0 publications

Military nutrition: maintaining health and rebuilding injured tissue

Military nutrition: maintaining health and rebuilding injured tissue

Controversies in the determination of energy requirements

Limitations of nutrient intake. The effect of stressors: trauma, sepsis and multiple organ failure

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