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A comparison of predictive equations of energy expenditure and measured energy expenditure in critically ill patients.
J Crit Care. 2012 Jun; 27(3):321.e5-12.JC

Abstract

PURPOSE

Multiple equations exist for predicting resting energy expenditure (REE). The accuracy of these for estimating energy requirements of critically ill patients is not clear, especially for obese patients. We sought to compare REE, calculated with published formulas, with measured REE in a cohort of mechanically ventilated subjects.

MATERIALS AND METHODS

We retrospectively identified all mechanically ventilated patients with measured body mass index who underwent indirect calorimetry in the intensive care unit. Limits of agreement and Pitman's test of difference in variance were performed to compare REE by equations with REE measured by indirect calorimetry.

RESULTS

A total of 927 patients were identified, including 401 obese patients. There were bias and poor agreement between measured REE and REE predicted by the Harris-Benedict, Owen, American College of Chest Physicians, and Mifflin equations (P > .05). There was poor agreement between measured and predicted REE by the Ireton-Jones equation, stratifying by sex. Ireton-Jones was the only equation that was unbiased for men and those in weight categories 1 and 2. In all cases except Ireton-Jones, predictive equations underestimated measured REE.

CONCLUSION

None of these equations accurately estimated measured REE in this group of mechanically ventilated patients, most underestimating energy needs. Development of improved predictive equations for adequate assessment of energy needs is needed.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, University of Washington Medical Center, Seattle, WA 98104, USA. ekross@u.washington.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

22425340

Citation

Kross, Erin K., et al. "A Comparison of Predictive Equations of Energy Expenditure and Measured Energy Expenditure in Critically Ill Patients." Journal of Critical Care, vol. 27, no. 3, 2012, pp. 321.e5-12.
Kross EK, Sena M, Schmidt K, et al. A comparison of predictive equations of energy expenditure and measured energy expenditure in critically ill patients. J Crit Care. 2012;27(3):321.e5-12.
Kross, E. K., Sena, M., Schmidt, K., & Stapleton, R. D. (2012). A comparison of predictive equations of energy expenditure and measured energy expenditure in critically ill patients. Journal of Critical Care, 27(3), e5-12. https://doi.org/10.1016/j.jcrc.2011.07.084
Kross EK, et al. A Comparison of Predictive Equations of Energy Expenditure and Measured Energy Expenditure in Critically Ill Patients. J Crit Care. 2012;27(3):321.e5-12. PubMed PMID: 22425340.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of predictive equations of energy expenditure and measured energy expenditure in critically ill patients. AU - Kross,Erin K, AU - Sena,Matthew, AU - Schmidt,Karyn, AU - Stapleton,Renee D, Y1 - 2012/03/14/ PY - 2011/01/04/received PY - 2011/07/09/revised PY - 2011/07/17/accepted PY - 2012/3/20/entrez PY - 2012/3/20/pubmed PY - 2012/10/2/medline SP - 321.e5 EP - 12 JF - Journal of critical care JO - J Crit Care VL - 27 IS - 3 N2 - PURPOSE: Multiple equations exist for predicting resting energy expenditure (REE). The accuracy of these for estimating energy requirements of critically ill patients is not clear, especially for obese patients. We sought to compare REE, calculated with published formulas, with measured REE in a cohort of mechanically ventilated subjects. MATERIALS AND METHODS: We retrospectively identified all mechanically ventilated patients with measured body mass index who underwent indirect calorimetry in the intensive care unit. Limits of agreement and Pitman's test of difference in variance were performed to compare REE by equations with REE measured by indirect calorimetry. RESULTS: A total of 927 patients were identified, including 401 obese patients. There were bias and poor agreement between measured REE and REE predicted by the Harris-Benedict, Owen, American College of Chest Physicians, and Mifflin equations (P > .05). There was poor agreement between measured and predicted REE by the Ireton-Jones equation, stratifying by sex. Ireton-Jones was the only equation that was unbiased for men and those in weight categories 1 and 2. In all cases except Ireton-Jones, predictive equations underestimated measured REE. CONCLUSION: None of these equations accurately estimated measured REE in this group of mechanically ventilated patients, most underestimating energy needs. Development of improved predictive equations for adequate assessment of energy needs is needed. SN - 1557-8615 UR - https://www.unboundmedicine.com/medline/citation/22425340/A_comparison_of_predictive_equations_of_energy_expenditure_and_measured_energy_expenditure_in_critically_ill_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0883-9441(12)00026-3 DB - PRIME DP - Unbound Medicine ER -