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Harris-Benedict Equation and Resting Energy Expenditure Estimates in Critically Ill Ventilator Patients.
Am J Crit Care. 2016 Jan; 25(1):e21-9.AJ

Abstract

BACKGROUND

In routine practice, assessment of the nutritional status of critically ill patients still relies on traditional methods such as anthropometric measurements, biochemical markers, and predictive equations.

OBJECTIVE

To compare resting energy expenditure measured by indirect calorimetry (REEIC) with REE calculated by using the Harris-Benedict equation with 3 different sources of body weight (from bed scale, REEHB1; ideal body weight, REEHB2; and predicted body weight, REEHB3).

METHODS

This study included 205 critically ill patients (115 men, 90 women) evaluated within the first 48 hours of admission and undergoing mechanical ventilation. REE was measured by indirect calorimetry for 30 minutes and calculated by using the Harris-Benedict equation with the 3 sources of body weight. Data were compared by the Bland-Altman method.

RESULTS

The values based on ideal and predicted body weight (REEHB2 and REEHB3) did not agree with REEIC. Bland-Altman analysis showed that the limits of agreement varied from +796.1 kcal/d to -559.6 kcal/d for REEHB2 and from +809.2 kcal/d to -564.7 kcal/d for REEHB3. REEIC and REEHB1 (body weight determined by bed scale) agreed the best; the bias was -18.8 kcal/d. However, REEHB1 still overestimated REEIC by +555.3 kcal/d and underestimated it by -593.0 kcal/d.

CONCLUSION

For measuring REE in critically ill patients undergoing mechanical ventilation, calculation via the Harris-Benedict equation, regardless of the source of body weight, cannot be substituted for indirect calorimetry.

Authors+Show Affiliations

Michele Ferreira Picolo is a dietitian, Alessandra Fabiane Lago is a physical therapist, Anibal Basile-Filho, Edson Antonio Nicolini, and Maria Auxiliadora-Martins are physicians, Divisão de Terapia Intensiva, Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil. Mayra Gonçalves Menegueti is a nurse, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. Altacílio Aparecido Nunes is a physician, Departamento de Medicina Social, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Olindo Assis Martins-Filho is a biochemist, Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil.Michele Ferreira Picolo is a dietitian, Alessandra Fabiane Lago is a physical therapist, Anibal Basile-Filho, Edson Antonio Nicolini, and Maria Auxiliadora-Martins are physicians, Divisão de Terapia Intensiva, Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil. Mayra Gonçalves Menegueti is a nurse, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. Altacílio Aparecido Nunes is a physician, Departamento de Medicina Social, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Olindo Assis Martins-Filho is a biochemist, Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil.Michele Ferreira Picolo is a dietitian, Alessandra Fabiane Lago is a physical therapist, Anibal Basile-Filho, Edson Antonio Nicolini, and Maria Auxiliadora-Martins are physicians, Divisão de Terapia Intensiva, Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil. Mayra Gonçalves Menegueti is a nurse, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. Altacílio Aparecido Nunes is a physician, Departamento de Medicina Social, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Olindo Assis Martins-Filho is a biochemist, Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil.Michele Ferreira Picolo is a dietitian, Alessandra Fabiane Lago is a physical therapist, Anibal Basile-Filho, Edson Antonio Nicolini, and Maria Auxiliadora-Martins are physicians, Divisão de Terapia Intensiva, Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil. Mayra Gonçalves Menegueti is a nurse, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. Altacílio Aparecido Nunes is a physician, Departamento de Medicina Social, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Olindo Assis Martins-Filho is a biochemist, Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil.Michele Ferreira Picolo is a dietitian, Alessandra Fabiane Lago is a physical therapist, Anibal Basile-Filho, Edson Antonio Nicolini, and Maria Auxiliadora-Martins are physicians, Divisão de Terapia Intensiva, Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil. Mayra Gonçalves Menegueti is a nurse, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. Altacílio Aparecido Nunes is a physician, Departamento de Medicina Social, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Olindo Assis Martins-Filho is a biochemist, Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil.Michele Ferreira Picolo is a dietitian, Alessandra Fabiane Lago is a physical therapist, Anibal Basile-Filho, Edson Antonio Nicolini, and Maria Auxiliadora-Martins are physicians, Divisão de Terapia Intensiva, Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil. Mayra Gonçalves Menegueti is a nurse, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. Altacílio Aparecido Nunes is a physician, Departamento de Medicina Social, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Olindo Assis Martins-Filho is a biochemist, Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil.Michele Ferreira Picolo is a dietitian, Alessandra Fabiane Lago is a physical therapist, Anibal Basile-Filho, Edson Antonio Nicolini, and Maria Auxiliadora-Martins are physicians, Divisão de Terapia Intensiva, Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil. Mayra Gonçalves Menegueti is a nurse, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. Altacílio Aparecido Nunes is a physician, Departamento de Medicina Social, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Olindo Assis Martins-Filho is a biochemist, Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil.Michele Ferreira Picolo is a dietitian, Alessandra Fabiane Lago is a physical therapist, Anibal Basile-Filho, Edson Antonio Nicolini, and Maria Auxiliadora-Martins are physicians, Divisão de Terapia Intensiva, Departamento de Cirurgia e Anatomia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil. Mayra Gonçalves Menegueti is a nurse, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. Altacílio Aparecido Nunes is a physician, Departamento de Medicina Social, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Olindo Assis Martins-Filho is a biochemist, Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil. mam_martins@hotmail.com.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26724304

Citation

Picolo, Michele Ferreira, et al. "Harris-Benedict Equation and Resting Energy Expenditure Estimates in Critically Ill Ventilator Patients." American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses, vol. 25, no. 1, 2016, pp. e21-9.
Picolo MF, Lago AF, Menegueti MG, et al. Harris-Benedict Equation and Resting Energy Expenditure Estimates in Critically Ill Ventilator Patients. Am J Crit Care. 2016;25(1):e21-9.
Picolo, M. F., Lago, A. F., Menegueti, M. G., Nicolini, E. A., Basile-Filho, A., Nunes, A. A., Martins-Filho, O. A., & Auxiliadora-Martins, M. (2016). Harris-Benedict Equation and Resting Energy Expenditure Estimates in Critically Ill Ventilator Patients. American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses, 25(1), e21-9. https://doi.org/10.4037/ajcc2016758
Picolo MF, et al. Harris-Benedict Equation and Resting Energy Expenditure Estimates in Critically Ill Ventilator Patients. Am J Crit Care. 2016;25(1):e21-9. PubMed PMID: 26724304.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Harris-Benedict Equation and Resting Energy Expenditure Estimates in Critically Ill Ventilator Patients. AU - Picolo,Michele Ferreira, AU - Lago,Alessandra Fabiane, AU - Menegueti,Mayra Gonçalves, AU - Nicolini,Edson Antonio, AU - Basile-Filho,Anibal, AU - Nunes,Altacílio Aparecido, AU - Martins-Filho,Olindo Assis, AU - Auxiliadora-Martins,Maria, PY - 2016/1/3/entrez PY - 2016/1/3/pubmed PY - 2016/9/24/medline SP - e21 EP - 9 JF - American journal of critical care : an official publication, American Association of Critical-Care Nurses JO - Am. J. Crit. Care VL - 25 IS - 1 N2 - BACKGROUND: In routine practice, assessment of the nutritional status of critically ill patients still relies on traditional methods such as anthropometric measurements, biochemical markers, and predictive equations. OBJECTIVE: To compare resting energy expenditure measured by indirect calorimetry (REEIC) with REE calculated by using the Harris-Benedict equation with 3 different sources of body weight (from bed scale, REEHB1; ideal body weight, REEHB2; and predicted body weight, REEHB3). METHODS: This study included 205 critically ill patients (115 men, 90 women) evaluated within the first 48 hours of admission and undergoing mechanical ventilation. REE was measured by indirect calorimetry for 30 minutes and calculated by using the Harris-Benedict equation with the 3 sources of body weight. Data were compared by the Bland-Altman method. RESULTS: The values based on ideal and predicted body weight (REEHB2 and REEHB3) did not agree with REEIC. Bland-Altman analysis showed that the limits of agreement varied from +796.1 kcal/d to -559.6 kcal/d for REEHB2 and from +809.2 kcal/d to -564.7 kcal/d for REEHB3. REEIC and REEHB1 (body weight determined by bed scale) agreed the best; the bias was -18.8 kcal/d. However, REEHB1 still overestimated REEIC by +555.3 kcal/d and underestimated it by -593.0 kcal/d. CONCLUSION: For measuring REE in critically ill patients undergoing mechanical ventilation, calculation via the Harris-Benedict equation, regardless of the source of body weight, cannot be substituted for indirect calorimetry. SN - 1937-710X UR - https://www.unboundmedicine.com/medline/citation/26724304/Harris_Benedict_Equation_and_Resting_Energy_Expenditure_Estimates_in_Critically_Ill_Ventilator_Patients_ L2 - https://aacnjournals.org/ajcconline/article-lookup/doi/10.4037/ajcc2016758 DB - PRIME DP - Unbound Medicine ER -