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Energy Expenditure in Critically Ill Elderly Patients: Indirect Calorimetry vs Predictive Equations.
JPEN J Parenter Enteral Nutr. 2017 07; 41(5):776-784.JJ

Abstract

BACKGROUND

Predictive equations (PEs) are used for estimating resting energy expenditure (REE) when the measurements obtained from indirect calorimetry (IC) are not available. This study evaluated the degree of agreement and the accuracy between the REE measured by IC (REE-IC) and REE estimated by PE (REE-PE) in mechanically ventilated elderly patients admitted to the intensive care unit (ICU).

METHODS

REE-IC of 97 critically ill elderly patients was compared with REE-PE by 6 PEs: Harris and Benedict (HB) multiplied by the correction factor of 1.2; European Society for Clinical Nutrition and Metabolism (ESPEN) using the minimum (ESPENmi), average (ESPENme), and maximum (ESPENma) values; Mifflin-St Jeor; Ireton-Jones (IJ); Fredrix; and Lührmann. Degree of agreement between REE-PE and REE-IC was analyzed by the interclass correlation coefficient and the Bland-Altman test. The accuracy was calculated by the percentage of male and/or female patients whose REE-PE values differ by up to ±10% in relation to REE-IC.

RESULTS

For both sexes, there was no difference for average REE-IC in kcal/kg when the values obtained with REE-PE by corrected HB and ESPENme were compared. A high level of agreement was demonstrated by corrected HB for both sexes, with greater accuracy for women. The best accuracy in the male group was obtained with the IJ equation but with a low level of agreement.

CONCLUSIONS

The effectiveness of PEs is limited for estimating REE of critically ill elderly patients. Nonetheless, HB multiplied by a correction factor of 1.2 can be used until a specific PE for this group of patients is developed.

Authors+Show Affiliations

1 Nutritional Therapy Multidisciplinary Team, Hospital Copa D'Or, Rua Figueiredo de Magalhães, Rio de Janeiro, Brazil.1 Nutritional Therapy Multidisciplinary Team, Hospital Copa D'Or, Rua Figueiredo de Magalhães, Rio de Janeiro, Brazil.1 Nutritional Therapy Multidisciplinary Team, Hospital Copa D'Or, Rua Figueiredo de Magalhães, Rio de Janeiro, Brazil.1 Nutritional Therapy Multidisciplinary Team, Hospital Copa D'Or, Rua Figueiredo de Magalhães, Rio de Janeiro, Brazil.1 Nutritional Therapy Multidisciplinary Team, Hospital Copa D'Or, Rua Figueiredo de Magalhães, Rio de Janeiro, Brazil.2 Institute of Nutrition, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, Rio de Janeiro, Brazil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26826262

Citation

Segadilha, Nara L A L., et al. "Energy Expenditure in Critically Ill Elderly Patients: Indirect Calorimetry Vs Predictive Equations." JPEN. Journal of Parenteral and Enteral Nutrition, vol. 41, no. 5, 2017, pp. 776-784.
Segadilha NLAL, Rocha EEM, Tanaka LMS, et al. Energy Expenditure in Critically Ill Elderly Patients: Indirect Calorimetry vs Predictive Equations. JPEN J Parenter Enteral Nutr. 2017;41(5):776-784.
Segadilha, N. L. A. L., Rocha, E. E. M., Tanaka, L. M. S., Gomes, K. L. P., Espinoza, R. E. A., & Peres, W. A. F. (2017). Energy Expenditure in Critically Ill Elderly Patients: Indirect Calorimetry vs Predictive Equations. JPEN. Journal of Parenteral and Enteral Nutrition, 41(5), 776-784. https://doi.org/10.1177/0148607115625609
Segadilha NLAL, et al. Energy Expenditure in Critically Ill Elderly Patients: Indirect Calorimetry Vs Predictive Equations. JPEN J Parenter Enteral Nutr. 2017;41(5):776-784. PubMed PMID: 26826262.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Energy Expenditure in Critically Ill Elderly Patients: Indirect Calorimetry vs Predictive Equations. AU - Segadilha,Nara L A L, AU - Rocha,Eduardo E M, AU - Tanaka,Lilian M S, AU - Gomes,Karla L P, AU - Espinoza,Rodolfo E A, AU - Peres,Wilza A F, Y1 - 2016/01/29/ PY - 2016/1/31/pubmed PY - 2018/5/8/medline PY - 2016/1/31/entrez KW - aged KW - critical care KW - indirect calorimetry KW - predictive equations KW - resting energy expenditure SP - 776 EP - 784 JF - JPEN. Journal of parenteral and enteral nutrition JO - JPEN J Parenter Enteral Nutr VL - 41 IS - 5 N2 - BACKGROUND: Predictive equations (PEs) are used for estimating resting energy expenditure (REE) when the measurements obtained from indirect calorimetry (IC) are not available. This study evaluated the degree of agreement and the accuracy between the REE measured by IC (REE-IC) and REE estimated by PE (REE-PE) in mechanically ventilated elderly patients admitted to the intensive care unit (ICU). METHODS: REE-IC of 97 critically ill elderly patients was compared with REE-PE by 6 PEs: Harris and Benedict (HB) multiplied by the correction factor of 1.2; European Society for Clinical Nutrition and Metabolism (ESPEN) using the minimum (ESPENmi), average (ESPENme), and maximum (ESPENma) values; Mifflin-St Jeor; Ireton-Jones (IJ); Fredrix; and Lührmann. Degree of agreement between REE-PE and REE-IC was analyzed by the interclass correlation coefficient and the Bland-Altman test. The accuracy was calculated by the percentage of male and/or female patients whose REE-PE values differ by up to ±10% in relation to REE-IC. RESULTS: For both sexes, there was no difference for average REE-IC in kcal/kg when the values obtained with REE-PE by corrected HB and ESPENme were compared. A high level of agreement was demonstrated by corrected HB for both sexes, with greater accuracy for women. The best accuracy in the male group was obtained with the IJ equation but with a low level of agreement. CONCLUSIONS: The effectiveness of PEs is limited for estimating REE of critically ill elderly patients. Nonetheless, HB multiplied by a correction factor of 1.2 can be used until a specific PE for this group of patients is developed. SN - 1941-2444 UR - https://www.unboundmedicine.com/medline/citation/26826262/Energy_Expenditure_in_Critically_Ill_Elderly_Patients:_Indirect_Calorimetry_vs_Predictive_Equations_ L2 - https://doi.org/10.1177/0148607115625609 DB - PRIME DP - Unbound Medicine ER -