Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Apr;48(3):267-274.
doi: 10.1002/jpen.2617. Epub 2024 Feb 26.

Estimates of resting energy expenditure using predictive equations in adults with severe burns: A systematic review and meta-analysis

Yiran Wang  1   2 , Jing Jiang  1   2 , Meixuan Liu  1   2 , Huan Liu  1   2 , Tao Shen  1 , Chunmao Han  1   2 , Xingang Wang  1   2
Affiliations
Meta-Analysis

Estimates of resting energy expenditure using predictive equations in adults with severe burns: A systematic review and meta-analysis

Yiran Wang et al. JPEN J Parenter Enteral Nutr. 2024 Apr.

Abstract

Background: Many equations to estimate the resting energy expenditure (REE) of patients with burns are currently available, but which of them provides the best guide to optimize nutrition support is controversial. This review examined the bias and precision of commonly used equations in patients with severe burns.

Methods: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases was undertaken on June 1, 2023, to identify studies comparing predicted REE (using equations) with measured REE (by indirect calorimetry [IC]) in adults with severe burns. Meta-analyses of bias and calculations of precisions were performed in each predictive equation, respectively.

Results: Nine eligible studies and 12 eligible equations were included. Among the equations, the Toronto equation had the lowest bias (26.1 kcal/day; 95% CI, -417.0 to 469.2), followed by the Harris-Benedict equation × 1.5 (1.5HB) and the Milner equation. The Ireton-Jones equation (303.4 kcal/day; 95% CI, 224.5-382.3) acceptably overestimated the REE. The accuracy of all of the equations was <50%. The Ireton-Jones equation had the relatively highest precision (41.2%), followed by the 1.5HB equation (37.0%) and the Toronto equation (34.7%).

Conclusion: For adult patients with severe burns, all of the commonly used equations for the prediction of REE are inaccurate. It is recommended to use IC for accurate REE measurements and to use the Toronto equation, 1.5HB equation, or Ireton-Jones equation as a reference when IC is not available. Further studies are needed to propose more accurate REE predictive models.

Keywords: energy expenditure; nutritional support; predictive equation resting; severe burn.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

REFERENCES

    1. Clark A, Imran J, Madni T, Wolf SE. Nutrition and metabolism in burn patients. Burns Trauma. 2017;5:11.
    1. Shahrokhi S, Jeschke MG. Metabolic and nutritional support. Surg Clin North Am. 2023;103(3):473‐482.
    1. Stapel SN, de Grooth H‐JS, Alimohamad H, et al. Ventilator‐derived carbon dioxide production to assess energy expenditure in critically ill patients: proof of concept. Crit Care. 2015;19:370.
    1. Weir JBV. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol. 1949;109(1‐2):1‐9.
    1. Dickerson R, Gervasio J, Riley M, et al. Accuracy of predictive methods to estimate resting energy expenditure of thermally‐injured patients. JPEN J Parenter Enteral Nutr. 2002;26(1):17‐29.

Publication types

LinkOut - more resources