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Can energy expenditure be predicted in critically ill children?.
Pediatr Crit Care Med. 2003 Apr; 4(2):176-80.PC

Abstract

OBJECTIVE

To determine whether critically ill children are hypermetabolic and to calculate whether predictive equations are appropriate for critically ill children.

DESIGN

Prospective, clinical study.

SETTING

Pediatric intensive care unit.

PATIENTS

A total of 57 children (39 boys) aged 9 months to 15.8 yrs.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The median resting energy expenditure measurement measured by indirect calorimetry was 37.2 (range, 11.9-66.6) kcal x kg(-1) x day(-1). This was significantly lower than would be predicted using either the Schofield (42.7 [26.9-65.4] kcal x kg(-1) x day(-1)) or Fleisch equations (42.8 [20.9-66.2] kcalx kg(-1)-1 x day(-1), p < .001) but significantly higher than the White equation developed specifically for pediatric intensive care units (26.2 [8.5-70.1] kcal x kg(-1),day(-1), p < .0001). Methods comparison analysis showed the limits of agreement were -484 to 300, -461 to 319, and -3.2 to 854 kcal/day, respectively. Multivariate analysis indicated the following factors contribute to hypometabolism and hypermetabolism: age (p = .006), sex (p = .034), time spent in the pediatric intensive care unit (p = .001), diagnosis (p = .015), weight (p = .009), temperature (p = .04), continuous infusion for sedation (p = .04), and neuromuscular blockade (p = .03).

CONCLUSION

Children do not become hypermetabolic during critical illness. These data suggest that agreement between resting energy expenditure and the predictive equations are so broad that they are inappropriate for use in critically ill children.

Authors+Show Affiliations

Institute of Liver Studies, King's College Hospital, London, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12749648

Citation

Taylor, Rachel M., et al. "Can Energy Expenditure Be Predicted in 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, vol. 4, no. 2, 2003, pp. 176-80.
Taylor RM, Cheeseman P, Preedy V, et al. Can energy expenditure be predicted in critically ill children?. Pediatr Crit Care Med. 2003;4(2):176-80.
Taylor, R. M., Cheeseman, P., Preedy, V., Baker, A. J., & Grimble, G. (2003). Can energy expenditure be predicted in 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, 4(2), 176-80.
Taylor RM, et al. Can Energy Expenditure Be Predicted in Critically Ill Children?. Pediatr Crit Care Med. 2003;4(2):176-80. PubMed PMID: 12749648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can energy expenditure be predicted in critically ill children?. AU - Taylor,Rachel M, AU - Cheeseman,Paul, AU - Preedy,Victor, AU - Baker,Alastair J, AU - Grimble,George, PY - 2003/5/17/pubmed PY - 2003/7/30/medline PY - 2003/5/17/entrez SP - 176 EP - 80 JF - Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies JO - Pediatr Crit Care Med VL - 4 IS - 2 N2 - OBJECTIVE: To determine whether critically ill children are hypermetabolic and to calculate whether predictive equations are appropriate for critically ill children. DESIGN: Prospective, clinical study. SETTING: Pediatric intensive care unit. PATIENTS: A total of 57 children (39 boys) aged 9 months to 15.8 yrs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The median resting energy expenditure measurement measured by indirect calorimetry was 37.2 (range, 11.9-66.6) kcal x kg(-1) x day(-1). This was significantly lower than would be predicted using either the Schofield (42.7 [26.9-65.4] kcal x kg(-1) x day(-1)) or Fleisch equations (42.8 [20.9-66.2] kcalx kg(-1)-1 x day(-1), p < .001) but significantly higher than the White equation developed specifically for pediatric intensive care units (26.2 [8.5-70.1] kcal x kg(-1),day(-1), p < .0001). Methods comparison analysis showed the limits of agreement were -484 to 300, -461 to 319, and -3.2 to 854 kcal/day, respectively. Multivariate analysis indicated the following factors contribute to hypometabolism and hypermetabolism: age (p = .006), sex (p = .034), time spent in the pediatric intensive care unit (p = .001), diagnosis (p = .015), weight (p = .009), temperature (p = .04), continuous infusion for sedation (p = .04), and neuromuscular blockade (p = .03). CONCLUSION: Children do not become hypermetabolic during critical illness. These data suggest that agreement between resting energy expenditure and the predictive equations are so broad that they are inappropriate for use in critically ill children. SN - 1529-7535 UR - https://www.unboundmedicine.com/medline/citation/12749648/Can_energy_expenditure_be_predicted_in_critically_ill_children_ L2 - http://Insights.ovid.com/pubmed?pmid=12749648 DB - PRIME DP - Unbound Medicine ER -