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Retrospective evaluation of commonly used equations to predict energy expenditure in mechanically ventilated, critically ill patients.
Pharmacotherapy 2004; 24(12):1659-67P

Abstract

STUDY OBJECTIVE

To determine which of four commonly used equations to estimate energy expenditure is precise and unbiased compared with energy expenditure as measured by indirect calorimetry.

DESIGN

Retrospective, observational study.

SETTING

Adult medical intensive care unit in a research hospital of the National Institutes of Health Clinical Center.

PATIENTS

Seventy-six adult, mechanically ventilated, critically ill patients.

INTERVENTION

Indirect calorimetry reports generated by the National Institutes of Health Critical Care Medicine Department's Metabolic Cart Consult Service were reviewed. Bias and precision of resting energy expenditure (REE) estimated by equations were computed using mean prediction error (ME) and root mean squared prediction error (MSE). Equations were considered precise if the 95% confidence interval for MSE was within 15% of the measured energy expenditure (MEE) determined by indirect calorimetry. Equations were considered unbiased if the 95% confidence interval for ME included zero. Paired t tests were used to compare estimated REE values for each predictive equation with MEE values determined by indirect calorimetry. Data were stratified into regions of bias using classification and regression tree analysis, as well as visual inspection of estimated REE-versus-MEE curves for each equation.

MEASUREMENTS AND MAIN RESULTS

The Harris-Benedict equation multiplied by an activity factor of 1.2 was unbiased and precise. The Ireton-Jones equation was precise but biased. The American College of Chest Physicians' consensus recommendation was biased and imprecise. The Harris-Benedict equation without an activity factor also demonstrated bias and imprecision.

CONCLUSIONS

The Harris-Benedict equation multiplied by an activity factor of 1.2 is suitable for predicting REE and may be used in the absence of indirect calorimetry.

Authors+Show Affiliations

Department of Pharmacy Services, Tampa General Hospital, Tampa, Florida 33601-1289, USA. ealexander@tgh.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15585435

Citation

Alexander, Earnest, et al. "Retrospective Evaluation of Commonly Used Equations to Predict Energy Expenditure in Mechanically Ventilated, Critically Ill Patients." Pharmacotherapy, vol. 24, no. 12, 2004, pp. 1659-67.
Alexander E, Susla GM, Burstein AH, et al. Retrospective evaluation of commonly used equations to predict energy expenditure in mechanically ventilated, critically ill patients. Pharmacotherapy. 2004;24(12):1659-67.
Alexander, E., Susla, G. M., Burstein, A. H., Brown, D. T., & Ognibene, F. P. (2004). Retrospective evaluation of commonly used equations to predict energy expenditure in mechanically ventilated, critically ill patients. Pharmacotherapy, 24(12), pp. 1659-67.
Alexander E, et al. Retrospective Evaluation of Commonly Used Equations to Predict Energy Expenditure in Mechanically Ventilated, Critically Ill Patients. Pharmacotherapy. 2004;24(12):1659-67. PubMed PMID: 15585435.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retrospective evaluation of commonly used equations to predict energy expenditure in mechanically ventilated, critically ill patients. AU - Alexander,Earnest, AU - Susla,Gregory M, AU - Burstein,Aaron H, AU - Brown,Dennis T, AU - Ognibene,Frederick P, PY - 2004/12/9/pubmed PY - 2005/1/27/medline PY - 2004/12/9/entrez SP - 1659 EP - 67 JF - Pharmacotherapy JO - Pharmacotherapy VL - 24 IS - 12 N2 - STUDY OBJECTIVE: To determine which of four commonly used equations to estimate energy expenditure is precise and unbiased compared with energy expenditure as measured by indirect calorimetry. DESIGN: Retrospective, observational study. SETTING: Adult medical intensive care unit in a research hospital of the National Institutes of Health Clinical Center. PATIENTS: Seventy-six adult, mechanically ventilated, critically ill patients. INTERVENTION: Indirect calorimetry reports generated by the National Institutes of Health Critical Care Medicine Department's Metabolic Cart Consult Service were reviewed. Bias and precision of resting energy expenditure (REE) estimated by equations were computed using mean prediction error (ME) and root mean squared prediction error (MSE). Equations were considered precise if the 95% confidence interval for MSE was within 15% of the measured energy expenditure (MEE) determined by indirect calorimetry. Equations were considered unbiased if the 95% confidence interval for ME included zero. Paired t tests were used to compare estimated REE values for each predictive equation with MEE values determined by indirect calorimetry. Data were stratified into regions of bias using classification and regression tree analysis, as well as visual inspection of estimated REE-versus-MEE curves for each equation. MEASUREMENTS AND MAIN RESULTS: The Harris-Benedict equation multiplied by an activity factor of 1.2 was unbiased and precise. The Ireton-Jones equation was precise but biased. The American College of Chest Physicians' consensus recommendation was biased and imprecise. The Harris-Benedict equation without an activity factor also demonstrated bias and imprecision. CONCLUSIONS: The Harris-Benedict equation multiplied by an activity factor of 1.2 is suitable for predicting REE and may be used in the absence of indirect calorimetry. SN - 0277-0008 UR - https://www.unboundmedicine.com/medline/citation/15585435/Retrospective_evaluation_of_commonly_used_equations_to_predict_energy_expenditure_in_mechanically_ventilated_critically_ill_patients_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0277-0008&date=2004&volume=24&issue=12&spage=1659 DB - PRIME DP - Unbound Medicine ER -