Energy expenditure and balance following pediatric intensive care unit admission: a longitudinal study of critically ill children

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Michiel J S OosterveldReinoud J B J Gemke

Abstract

Longitudinal comparison of prescribed energy, actually administered energy, and energy expenditure (EE) predicted by Schofield's equations to actual EE, as determined by daily indirect calorimetry measurements in critically ill children during the first 7 days following admission. Observational study. Pediatric intensive care unit, high and medium care wards, in a university hospital. Forty-six mechanically ventilated and spontaneously breathing infants and children (0-18 yrs) who were admitted with sepsis or following major abdominal or thoracic surgery or trauma. Daily indirect calorimetry measurements and assessment of energy balance. Energy balance studies were performed for a total of 298 admission days in 13 sepsis, 27 surgery, and 6 trauma patients. Indirect calorimetry measurements were performed on 89% of the days. Mean measured EE was 44.6 +/- 15 kcal/kg.d and equaled predicted EE (44.2 +/- 12 kcal/kg.d; p = .56). Measured EE did not change over time, neither overall nor in diagnostic subgroups. Overall, median (range) administered energy was 31.1 (0-119) kcal/kg.d, which was significantly lower than measured EE (p < .001) and predicted EE (p < .001). Patients were underfed on 60% of days and overfed on 28% of days. A...Continue Reading

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