# Comparison of formulaic equations to determine energy expenditure in the critically ill patient.

### Abstract

### OBJECTIVE

Inappropriate energy intake can negatively affect patient outcome during critical illness. Measuring energy expenditure via indirect calorimetry (IC) is the most accurate method of determining needs. Often predictive equations are used because IC is not available at all institutions or for all populations.### METHODS

This study compared 24-h IC measures with five previously published formulaic equations and nomograms using kilocalorie per kilogram of body weight to determine their accuracy in predicting energy needs in critically ill adults receiving nutrition support. Two different weight categories were analyzed: body mass indexes below 25 kg/m(2) and below 30 kg/m(2).### RESULTS

The Harris-Benedict equation using adjusted body weight multiplied by a stress factor of 1.6 and the Swinamer equation predicted measured energy expenditure (MEE) within 20% of IC values 80% of the time for the entire population studied. For those individuals at the lower weight range, the Harris-Benedict equation using actual weight reference weight via the Hamwi equation and via adjusted weight times a stress factor of 1.6 and the Swinamer equation predicted MEE within 20% of IC values 89% of the time. The Frankenfield equation overestimated MEE; whereas the Penn State and Ireton-Jones equations underestimated energy needs in the population studied.### CONCLUSIONS

Predictive equations such as the Harris-Benedict equation multiplied by a stress factor of 1.6 and the Swinamer equation may be accurate enough for short-term nutrition support of critically ill patients when IC is unavailable.### Links

### Authors+Show Affiliations

,St. John Health System, Detroit, Michigan 48859, USA.

### Source

Nutrition (Burbank, Los Angeles County, Calif.) 19:3 2003 Mar pg 233-9

### MeSH

Body Mass IndexBody Weight

Calorimetry, Indirect

Critical Illness

Energy Intake

Energy Metabolism

Female

Humans

Male

Mathematics

Middle Aged

Nutritional Requirements

Nutritional Support

Predictive Value of Tests

Retrospective Studies

Sensitivity and Specificity

### Pub Type(s)

Comparative StudyJournal Article

### Language

eng

### PubMed ID

12620525

### Citation

MacDonald, Angela, and Leslie Hildebrandt. "Comparison of Formulaic Equations to Determine Energy Expenditure in the Critically Ill Patient."

*Nutrition (Burbank, Los Angeles County, Calif.),*vol. 19, no. 3, 2003, pp. 233-9.MacDonald A, Hildebrandt L. Comparison of formulaic equations to determine energy expenditure in the critically ill patient.

*Nutrition*. 2003;19(3):233-9.MacDonald, A., & Hildebrandt, L. (2003). Comparison of formulaic equations to determine energy expenditure in the critically ill patient.

*Nutrition (Burbank, Los Angeles County, Calif.),**19*(3), pp. 233-9.MacDonald A, Hildebrandt L. Comparison of Formulaic Equations to Determine Energy Expenditure in the Critically Ill Patient.

*Nutrition.*2003;19(3):233-9. PubMed PMID: 12620525.* Article titles in AMA citation format should be in sentence-case

TY - JOUR
T1 - Comparison of formulaic equations to determine energy expenditure in the critically ill patient.
AU - MacDonald,Angela,
AU - Hildebrandt,Leslie,
PY - 2003/3/7/pubmed
PY - 2003/7/18/medline
PY - 2003/3/7/entrez
SP - 233
EP - 9
JF - Nutrition (Burbank, Los Angeles County, Calif.)
JO - Nutrition
VL - 19
IS - 3
N2 - OBJECTIVE: Inappropriate energy intake can negatively affect patient outcome during critical illness. Measuring energy expenditure via indirect calorimetry (IC) is the most accurate method of determining needs. Often predictive equations are used because IC is not available at all institutions or for all populations. METHODS: This study compared 24-h IC measures with five previously published formulaic equations and nomograms using kilocalorie per kilogram of body weight to determine their accuracy in predicting energy needs in critically ill adults receiving nutrition support. Two different weight categories were analyzed: body mass indexes below 25 kg/m(2) and below 30 kg/m(2). RESULTS: The Harris-Benedict equation using adjusted body weight multiplied by a stress factor of 1.6 and the Swinamer equation predicted measured energy expenditure (MEE) within 20% of IC values 80% of the time for the entire population studied. For those individuals at the lower weight range, the Harris-Benedict equation using actual weight reference weight via the Hamwi equation and via adjusted weight times a stress factor of 1.6 and the Swinamer equation predicted MEE within 20% of IC values 89% of the time. The Frankenfield equation overestimated MEE; whereas the Penn State and Ireton-Jones equations underestimated energy needs in the population studied. CONCLUSIONS: Predictive equations such as the Harris-Benedict equation multiplied by a stress factor of 1.6 and the Swinamer equation may be accurate enough for short-term nutrition support of critically ill patients when IC is unavailable.
SN - 0899-9007
UR - https://www.unboundmedicine.com/medline/citation/12620525/Comparison_of_formulaic_equations_to_determine_energy_expenditure_in_the_critically_ill_patient_
L2 - https://linkinghub.elsevier.com/retrieve/pii/S089990070201033X
DB - PRIME
DP - Unbound Medicine
ER -