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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.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

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

    Source

    MeSH

    Body Mass Index
    Body 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 Study
    Journal 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 -