Validation of ventilator-derived VCO2 measurements to determine energy expenditure in ventilated critically ill children

Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition
Dorian KerklaanKoen F M Joosten

Abstract

Indirect calorimetry (IC) is considered the gold standard to determine resting energy expenditure (REE) but its availability in PICUs worldwide is limited. Ventilator-derived VCO2 could potentially improve the possibility of performing REE measurements. We investigated whether ventilator-derived VCO2 values are comparable to IC-derived VCO2 values and can clinically be used in clinical practice to determine REE. VCO2-values were simultaneously collected in mechanically ventilated children from IC (Deltatrac®) and Servo-I® ventilator on a minute base over at least 10 min period of steady state. REE was calculated using the modified Weir formula (for IC) or REE = 5.5*VCO2 (L/min)*1440 (for the Servo-I values) and compared with frequently used predictive equations by Schofield and the WHO to calculate REE. Measurements were performed in 41 children; median age 2 years. The mean relative difference between VCO2 measured by IC and Servo-I® was 15.6% (p = 0.002), and limits of agreement in the Bland-Altman analysis were wide. Comparable measurements, defined as a difference ≤10% between IC and Servo-I® VCO2 values, were seen in 18 (44%) children, but this proportion was 70% in children ≥15 kg. In this group, REE could be accurately p...Continue Reading

Citations

Jun 19, 2018·Current Opinion in Clinical Nutrition and Metabolic Care·Najate AchamrahLaurence Genton
Apr 6, 2017·Critical Care : the Official Journal of the Critical Care Forum·Sandra N StapelHeleen M Oudemans-van Straaten
Jul 12, 2017·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Nilesh M MehtaCarol Braunschweig
Apr 1, 2018·JPEN. Journal of Parenteral and Enteral Nutrition·Corinne Jotterand ChaparroJacques Cotting
Jun 9, 2020·The International Journal of Eating Disorders·Brigitte KochaviDaniel Stein
Jun 22, 2016·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Sidharth Kumar SethiRupesh Raina
Apr 16, 2021·Minerva anestesiologica·Ben D AlbertNilesh M Mehta

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