Energy expenditure in critically ill patients estimated by population-based equations, indirect calorimetry and CO2-based indirect calorimetry

Annals of Intensive Care
Mark Lillelund RousingJean-Charles Preiser

Abstract

Indirect calorimetry (IC) is the reference method for measurement of energy expenditure (EE) in mechanically ventilated critically ill patients. When IC is unavailable, EE can be calculated by predictive equations or by VCO2-based calorimetry. This study compares the bias, quality and accuracy of these methods. EE was determined by IC over a 30-min period in patients from a mixed medical/postsurgical intensive care unit and compared to seven predictive equations and to VCO2-based calorimetry. The bias was described by the mean difference between predicted EE and IC, the quality by the root mean square error (RMSE) of the difference and the accuracy by the number of patients with estimates within 10 % of IC. Errors of VCO2-based calorimetry due to choice of respiratory quotient (RQ) were determined by a sensitivity analysis, and errors due to fluctuations in ventilation were explored by a qualitative analysis. In 18 patients (mean age 61 ± 17 years, five women), EE averaged 2347 kcal/day. All predictive equations were accurate in less than 50 % of the patients with an RMSE ≥ 15 %. VCO2-based calorimetry was accurate in 89 % of patients, significantly better than all predictive equations, and remained better for any choice of RQ ...Continue Reading

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Citations

Apr 6, 2017·Critical Care : the Official Journal of the Critical Care Forum·Sandra N StapelHeleen M Oudemans-van Straaten
Jun 19, 2018·Current Opinion in Clinical Nutrition and Metabolic Care·Najate AchamrahLaurence Genton
Sep 1, 2020·AACN Advanced Critical Care·Makayla CordozaHilaire Thompson
Aug 6, 2016·Critical Care : the Official Journal of the Critical Care Forum·Ulrike Pielmeier, Steen Andreassen
Jan 22, 2017·Critical Care : the Official Journal of the Critical Care Forum·Taku OshimaClaude Pichard
Mar 19, 2020·Nutrients·Moran Hellerman Itzhaki, Pierre Singer
Sep 8, 2019·Journal of Clinical Medicine·Marta DelsoglioClaude Pichard
Mar 23, 2021·Clinical Nutrition ESPEN·Priscila S BarcellosDuarte P M Torres

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Methods Mentioned

BETA
sedation

Software Mentioned

Deltatrac Metabolic Monitor

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