Tags

Type your tag names separated by a space and hit enter

Can We Rely on Predicted Basal Metabolic Rate in Patients With Intestinal Failure on Home Parenteral Nutrition?
JPEN J Parenter Enteral Nutr 2017; 41(7):1139-1145JJ

Abstract

BACKGROUND AND AIMS

Intestinal failure (IF) is a serious and common complication of short bowel syndrome with patients depending on parenteral nutrition (PN) support. Effective nutrition management requires an accurate estimation of the patient's basal metabolic rate (BMR) to avoid underfeeding or overfeeding. However, indirect calorimetry, considered the gold standard for BMR assessment, is a time- and resource-consuming procedure. Consequently, several equations for prediction of BMR have been developed in different settings, but their accuracy in patients with IF are yet to be investigated. We evaluated the accuracy of predicted BMR in clinically stable patients with IF dependent on home parenteral nutrition (HPN).

METHODS

In total, 103 patients with IF were included. We used indirect calorimetry for assessment of BMR and calculated predicted BMR using different equations based on anthropometric and/or bioelectrical impedance parameters. The accuracy of predicted BMR was evaluated using Bland-Altman analysis with measured BMR as the gold standard.

RESULTS

The average measured BMR was 1272 ± 245 kcal/d. The most accurate estimations of BMR were obtained using the Harris-Benedict equation (mean bias, 14 kcal/d [ P = .28]; limits of agreement [LoA], -238 to 266 kcal/d) and the Johnstone equation (mean bias, -16 kcal/d [ P = .24]; LoA, -285 to 253 kcal/d). For both equations, 67% of patients had a predicted BMR from 90%-110% All other equations demonstrated a statistically and clinically significant difference between measured and predicted BMR.

CONCLUSIONS

The Harris-Benedict and Johnstone equations reliably predict BMR in two-thirds of clinically stable patients with IF on HPN.

Authors+Show Affiliations

1 Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, and Clinical Institute, Aalborg University, Aalborg, Denmark.1 Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, and Clinical Institute, Aalborg University, Aalborg, Denmark.1 Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, and Clinical Institute, Aalborg University, Aalborg, Denmark. 2 Mech-Sense, Department of Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg, Denmark.1 Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, and Clinical Institute, Aalborg University, Aalborg, Denmark.1 Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, and Clinical Institute, Aalborg University, Aalborg, Denmark.1 Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, and Clinical Institute, Aalborg University, Aalborg, Denmark.

Pub Type(s)

Journal Article
Validation Study

Language

eng

PubMed ID

27358330

Citation

Skallerup, Anders, et al. "Can We Rely On Predicted Basal Metabolic Rate in Patients With Intestinal Failure On Home Parenteral Nutrition?" JPEN. Journal of Parenteral and Enteral Nutrition, vol. 41, no. 7, 2017, pp. 1139-1145.
Skallerup A, Nygaard L, Olesen SS, et al. Can We Rely on Predicted Basal Metabolic Rate in Patients With Intestinal Failure on Home Parenteral Nutrition? JPEN J Parenter Enteral Nutr. 2017;41(7):1139-1145.
Skallerup, A., Nygaard, L., Olesen, S. S., Vinter-Jensen, L., Køhler, M., & Rasmussen, H. H. (2017). Can We Rely on Predicted Basal Metabolic Rate in Patients With Intestinal Failure on Home Parenteral Nutrition? JPEN. Journal of Parenteral and Enteral Nutrition, 41(7), pp. 1139-1145. doi:10.1177/0148607116657648.
Skallerup A, et al. Can We Rely On Predicted Basal Metabolic Rate in Patients With Intestinal Failure On Home Parenteral Nutrition. JPEN J Parenter Enteral Nutr. 2017;41(7):1139-1145. PubMed PMID: 27358330.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can We Rely on Predicted Basal Metabolic Rate in Patients With Intestinal Failure on Home Parenteral Nutrition? AU - Skallerup,Anders, AU - Nygaard,Louis, AU - Olesen,Søren Schou, AU - Vinter-Jensen,Lars, AU - Køhler,Marianne, AU - Rasmussen,Henrik Højgaard, Y1 - 2016/06/29/ PY - 2016/7/1/pubmed PY - 2018/6/12/medline PY - 2016/7/1/entrez KW - basal metabolic rate KW - bioelectrical impedance analysis KW - indirect calorimetry KW - intestinal failure KW - parenteral nutrition KW - predictive equations SP - 1139 EP - 1145 JF - JPEN. Journal of parenteral and enteral nutrition JO - JPEN J Parenter Enteral Nutr VL - 41 IS - 7 N2 - BACKGROUND AND AIMS: Intestinal failure (IF) is a serious and common complication of short bowel syndrome with patients depending on parenteral nutrition (PN) support. Effective nutrition management requires an accurate estimation of the patient's basal metabolic rate (BMR) to avoid underfeeding or overfeeding. However, indirect calorimetry, considered the gold standard for BMR assessment, is a time- and resource-consuming procedure. Consequently, several equations for prediction of BMR have been developed in different settings, but their accuracy in patients with IF are yet to be investigated. We evaluated the accuracy of predicted BMR in clinically stable patients with IF dependent on home parenteral nutrition (HPN). METHODS: In total, 103 patients with IF were included. We used indirect calorimetry for assessment of BMR and calculated predicted BMR using different equations based on anthropometric and/or bioelectrical impedance parameters. The accuracy of predicted BMR was evaluated using Bland-Altman analysis with measured BMR as the gold standard. RESULTS: The average measured BMR was 1272 ± 245 kcal/d. The most accurate estimations of BMR were obtained using the Harris-Benedict equation (mean bias, 14 kcal/d [ P = .28]; limits of agreement [LoA], -238 to 266 kcal/d) and the Johnstone equation (mean bias, -16 kcal/d [ P = .24]; LoA, -285 to 253 kcal/d). For both equations, 67% of patients had a predicted BMR from 90%-110% All other equations demonstrated a statistically and clinically significant difference between measured and predicted BMR. CONCLUSIONS: The Harris-Benedict and Johnstone equations reliably predict BMR in two-thirds of clinically stable patients with IF on HPN. SN - 1941-2444 UR - https://www.unboundmedicine.com/medline/citation/27358330/Can_We_Rely_on_Predicted_Basal_Metabolic_Rate_in_Patients_With_Intestinal_Failure_on_Home_Parenteral_Nutrition L2 - https://doi.org/10.1177/0148607116657648 DB - PRIME DP - Unbound Medicine ER -