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Adequate feeding and the usefulness of the respiratory quotient in critically ill children.
Nutrition. 2005 Feb; 21(2):192-8.N

Abstract

OBJECTIVE

We determined incidences of underfeeding and overfeeding in children who were admitted to a multidisciplinary tertiary pediatric intensive care and evaluated the usefulness of the respiratory quotient (RQ) obtained from indirect calorimetry to assess feeding adequacy.

METHODS

Children 18 y and younger who fulfilled the criteria for indirect calorimetry entered our prospective, observational study and were studied until day 14. Actual energy intake was recorded, compared with required energy intake (measured energy expenditure plus 10%), and classified as underfeeding (<90% of required), adequate feeding (90% to 110% of required), or overfeeding (>110% of required). We also evaluated the adequacy of a measured RQ lower than 0.85 to identify underfeeding, and an RQ higher than 1.0 to identify overfeeding.

RESULTS

Ninety-eight children underwent 195 calorimetric measurements. Underfeeding, adequate feeding, and overfeeding occurred on 21%, 10%, and 69% of days, respectively. An RQ lower than 0.85 to identify underfeeding showed low sensitivity (63%), high specificity (89%), and high negative predictive value (90%). An RQ higher than 1.0 to indicate overfeeding showed poor sensitivity (21%), but a high specificity (97%) and a high positive predictive value (93%). Food composition, notably high-carbohydrate intake, was responsible for an RQ exceeding 1.0 in the overfed group.

CONCLUSION

Children admitted to the intensive care unit receive adequate feeding on only 10% of measurement days during the first 2 wk of admission. The usefulness of RQ to monitor feeding adequacy is limited to identifying (carbohydrate) overfeeding and excluding underfeeding.

Authors+Show Affiliations

Department of Pediatric Surgery, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15723748

Citation

Hulst, Jessie M., et al. "Adequate Feeding and the Usefulness of the Respiratory Quotient in Critically Ill Children." Nutrition (Burbank, Los Angeles County, Calif.), vol. 21, no. 2, 2005, pp. 192-8.
Hulst JM, van Goudoever JB, Zimmermann LJ, et al. Adequate feeding and the usefulness of the respiratory quotient in critically ill children. Nutrition. 2005;21(2):192-8.
Hulst, J. M., van Goudoever, J. B., Zimmermann, L. J., Hop, W. C., Büller, H. A., Tibboel, D., & Joosten, K. F. (2005). Adequate feeding and the usefulness of the respiratory quotient in critically ill children. Nutrition (Burbank, Los Angeles County, Calif.), 21(2), 192-8.
Hulst JM, et al. Adequate Feeding and the Usefulness of the Respiratory Quotient in Critically Ill Children. Nutrition. 2005;21(2):192-8. PubMed PMID: 15723748.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adequate feeding and the usefulness of the respiratory quotient in critically ill children. AU - Hulst,Jessie M, AU - van Goudoever,Johannes B, AU - Zimmermann,Luc J, AU - Hop,Wim C, AU - Büller,Hans A, AU - Tibboel,Dick, AU - Joosten,Koen F M, PY - 2003/10/24/received PY - 2003/10/24/revised PY - 2004/05/26/accepted PY - 2005/2/23/pubmed PY - 2005/5/12/medline PY - 2005/2/23/entrez SP - 192 EP - 8 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 21 IS - 2 N2 - OBJECTIVE: We determined incidences of underfeeding and overfeeding in children who were admitted to a multidisciplinary tertiary pediatric intensive care and evaluated the usefulness of the respiratory quotient (RQ) obtained from indirect calorimetry to assess feeding adequacy. METHODS: Children 18 y and younger who fulfilled the criteria for indirect calorimetry entered our prospective, observational study and were studied until day 14. Actual energy intake was recorded, compared with required energy intake (measured energy expenditure plus 10%), and classified as underfeeding (<90% of required), adequate feeding (90% to 110% of required), or overfeeding (>110% of required). We also evaluated the adequacy of a measured RQ lower than 0.85 to identify underfeeding, and an RQ higher than 1.0 to identify overfeeding. RESULTS: Ninety-eight children underwent 195 calorimetric measurements. Underfeeding, adequate feeding, and overfeeding occurred on 21%, 10%, and 69% of days, respectively. An RQ lower than 0.85 to identify underfeeding showed low sensitivity (63%), high specificity (89%), and high negative predictive value (90%). An RQ higher than 1.0 to indicate overfeeding showed poor sensitivity (21%), but a high specificity (97%) and a high positive predictive value (93%). Food composition, notably high-carbohydrate intake, was responsible for an RQ exceeding 1.0 in the overfed group. CONCLUSION: Children admitted to the intensive care unit receive adequate feeding on only 10% of measurement days during the first 2 wk of admission. The usefulness of RQ to monitor feeding adequacy is limited to identifying (carbohydrate) overfeeding and excluding underfeeding. SN - 0899-9007 UR - https://www.unboundmedicine.com/medline/citation/15723748/Adequate_feeding_and_the_usefulness_of_the_respiratory_quotient_in_critically_ill_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(04)00248-5 DB - PRIME DP - Unbound Medicine ER -