Associations of measured resting energy expenditure with predictive equations, NUTRIC score, and patient outcomes
- PMID: 34690491
- PMCID: PMC8520770
- DOI: 10.1186/s43162-021-00060-1
Associations of measured resting energy expenditure with predictive equations, NUTRIC score, and patient outcomes
Abstract
Background: Indirect calorimetry is the reference method for measuring resting energy expenditure (REE), but the necessary equipment and technical expertise are not always available. Meanwhile, the NUTrition Risk in the Critically ill (NUTRIC) scale is designed to identify patients who would benefit from nutrition therapy, but no data are available regarding the association of NUTRIC scores with REE. Several predictive formulas are available as alternatives to indirect calorimetry for calculation of energy requirements, but they have not been compared in a homogeneous group of critically ill patients. The purpose of the study is to examine the correlations between energy expenditure and NUTRIC scores or patient outcomes, and to compare measured REE with estimations of energy expenditure.
Methods: In this observational, prospective study, indirect calorimetry was performed on 50 mechanically ventilated patients. Energy expenditure was also estimated with the bodyweight-based, Faisy-Fagon, and Penn-State PSUm equations.
Results: REE was higher in patients who survived treatment than in those who died, and was positively correlated with length of stay and duration of ventilation. NUTRIC scores did not correlate with REE. The Faisy-Fagon equation overestimated expenditure, whereas PSUm was unbiased and accurate. Calculations based on 25 kcal/kg bodyweight/day overestimated expenditure, whereas 23 kcal/kg/day produced unbiased estimates with greater accuracy than PSUm.
Conclusion: REE was positively associated with patient outcomes. Energy expenditure was accurately predicted by calculations of 23 kcal/kg bodyweight/day.
Keywords: Faisy–Fagon; Indirect calorimetry; NUTRIC score; PSUm; REE; Weight-based formula.
© The Author(s) 2021.
Conflict of interest statement
Competing interestsThe authors declare that they have no competing interests.
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References
-
- McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, Ochoa JB, Napolitano L, Cresci G, A.S.P.E.N. Board of Directors; American College of Critical Care Medicine; Society of Critical Care Medicine: Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr 2009, 33(3):277-316. - PubMed
-
- Kothandaramanujam RM, Arunkumar AS. MON-LB266: assessing nutritional risk in critically ill mechanically ventilated patients—Subjective Global Assessment (SGA), Nutrition Risk in Critically Ill (NUTRIC) score or a combination? Clin Nutr. 2016;35:S250–S251. doi: 10.1016/S0261-5614(16)30900-1. - DOI
-
- Mendes R, Policarpo S, Fortuna P, Alves M, Virella D, Heyland DK, Portuguese NUTRIC Study Group Nutritional risk assessment and cultural validation of the modified NUTRIC score in critically ill patients—a multicenter prospective cohort study. J Crit Care. 2017;37:45–49. doi: 10.1016/j.jcrc.2016.08.001. - DOI - PubMed
-
- Savard JF, Faisy C, Lerolle N, et al. Validation of a predictive method for an accurate assessment of resting energy expenditure in medical mechanically ventilated patients- Crit Care Med 2008;36, No. 4. - PubMed
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