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Measured versus calculated energy expenditure in pressure support ventilated ICU patients.
Minerva Anestesiol 1996; 62(5):165-70MA

Abstract

OBJECTIVE

To evaluate the usefulness of the modified Harris-Benedict formula predicting Energy Expenditure (EE) in pressure support ventilated, critically ill patient.

SETTING

The intensive care unit (ICU) of a teaching hospital.

PATIENTS

Fiftyfive patients admitted to ICU for acute respiratory failure, requiring mechanical ventilation.

MEASUREMENTS AND RESULTS

After 12 hours at rest, EE was measured using indirect calorimetry (Datex-Deltatrac, with method exclusions - ICEE), and calculated using modified Harris-Benedict formula (MHBEE) (with correction for "hospital activity" and "stress factor") to calculate the bias between calculated and measured EE. Patients were divided into three groups on the basis of nutritional stress: A) non surgical/non septic patients (n = 10), B) complicated surgical patients (n = 21), C) severe infectious/multiple trauma patients (n = 24). In each group, a good correlation between calculated and measured EE was found [A) r = 0.809, p = 0.0046; B) r = 0.753 p = 0.0001; C) r = 0.711, p = 0.0001]. The bias (+/- SEM) was: A 175.1 (+/- 82) kcal/day, B 324.5 (+/- 64.5) kcal/day, C 366.7 (+/- 62.9) kcal/day. The mean difference value seems to be increased in the more stressed patients but these differences did not reach statistical significance (p = 0.23). A single correction factor for the original Harris-Benedict formula (OHBEE) was also calculated (ICEE/OHBEE) on each studied group: A) 1.20 (+/- 0.04), B) 1.28 (+/- 0.03), C) 1.50 (+/- 0.04) (p = 0.0001).

CONCLUSIONS

The use of both "stress" and "activity" correction factors seems to be excessive in pressure support ventilated ICU patients. A single correction factor, proportional to the intensity of the illness, should be used in mechanically ventilated patients. Compared to the original Harris-Benedict formula, we found an EE increment of about 20%, 30%, and 50% respectively in non-septic/non-complicated, surgical complicated, and multiple trauma/septic patients.

Authors+Show Affiliations

IRCCS H San Raffaele, University of Milan, Department of Anesthesia and Intensive Care.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8937040

Citation

Casati, A, et al. "Measured Versus Calculated Energy Expenditure in Pressure Support Ventilated ICU Patients." Minerva Anestesiologica, vol. 62, no. 5, 1996, pp. 165-70.
Casati A, Colombo S, Leggieri C, et al. Measured versus calculated energy expenditure in pressure support ventilated ICU patients. Minerva Anestesiol. 1996;62(5):165-70.
Casati, A., Colombo, S., Leggieri, C., Muttini, S., Capocasa, T., & Gallioli, G. (1996). Measured versus calculated energy expenditure in pressure support ventilated ICU patients. Minerva Anestesiologica, 62(5), pp. 165-70.
Casati A, et al. Measured Versus Calculated Energy Expenditure in Pressure Support Ventilated ICU Patients. Minerva Anestesiol. 1996;62(5):165-70. PubMed PMID: 8937040.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Measured versus calculated energy expenditure in pressure support ventilated ICU patients. AU - Casati,A, AU - Colombo,S, AU - Leggieri,C, AU - Muttini,S, AU - Capocasa,T, AU - Gallioli,G, PY - 1996/5/1/pubmed PY - 1996/5/1/medline PY - 1996/5/1/entrez SP - 165 EP - 70 JF - Minerva anestesiologica JO - Minerva Anestesiol VL - 62 IS - 5 N2 - OBJECTIVE: To evaluate the usefulness of the modified Harris-Benedict formula predicting Energy Expenditure (EE) in pressure support ventilated, critically ill patient. SETTING: The intensive care unit (ICU) of a teaching hospital. PATIENTS: Fiftyfive patients admitted to ICU for acute respiratory failure, requiring mechanical ventilation. MEASUREMENTS AND RESULTS: After 12 hours at rest, EE was measured using indirect calorimetry (Datex-Deltatrac, with method exclusions - ICEE), and calculated using modified Harris-Benedict formula (MHBEE) (with correction for "hospital activity" and "stress factor") to calculate the bias between calculated and measured EE. Patients were divided into three groups on the basis of nutritional stress: A) non surgical/non septic patients (n = 10), B) complicated surgical patients (n = 21), C) severe infectious/multiple trauma patients (n = 24). In each group, a good correlation between calculated and measured EE was found [A) r = 0.809, p = 0.0046; B) r = 0.753 p = 0.0001; C) r = 0.711, p = 0.0001]. The bias (+/- SEM) was: A 175.1 (+/- 82) kcal/day, B 324.5 (+/- 64.5) kcal/day, C 366.7 (+/- 62.9) kcal/day. The mean difference value seems to be increased in the more stressed patients but these differences did not reach statistical significance (p = 0.23). A single correction factor for the original Harris-Benedict formula (OHBEE) was also calculated (ICEE/OHBEE) on each studied group: A) 1.20 (+/- 0.04), B) 1.28 (+/- 0.03), C) 1.50 (+/- 0.04) (p = 0.0001). CONCLUSIONS: The use of both "stress" and "activity" correction factors seems to be excessive in pressure support ventilated ICU patients. A single correction factor, proportional to the intensity of the illness, should be used in mechanically ventilated patients. Compared to the original Harris-Benedict formula, we found an EE increment of about 20%, 30%, and 50% respectively in non-septic/non-complicated, surgical complicated, and multiple trauma/septic patients. SN - 0375-9393 UR - https://www.unboundmedicine.com/medline/citation/8937040/Measured_versus_calculated_energy_expenditure_in_pressure_support_ventilated_ICU_patients_ L2 - https://medlineplus.gov/respiratoryfailure.html DB - PRIME DP - Unbound Medicine ER -