4.2 Review

Indirect calorimetry: should it be part of routine care or only used in specific situations?

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Article Nutrition & Dietetics

Dynamic metabolic changes measured by indirect calorimetry during the early phase of septic shock: a prospective observational pilot study

Emilie Occhiali et al.

Summary: This study aimed to describe the energy metabolism in early septic shock using indirect calorimetry. The results showed that energy deficit improved while resting energy expenditure and respiratory quotient remained stable during the first week of ICU stay. There were changes in substrate utilization, particularly an increase in protein consumption, which warrants further exploration with larger studies.

EUROPEAN JOURNAL OF CLINICAL NUTRITION (2022)

Article Nutrition & Dietetics

Estimated vs measured energy expenditure in ventilated surgical-trauma critically ill patients

Amir Y. Kamel et al.

Summary: This study evaluated the agreement and accuracy between indirect calorimetry and ten different predictive equations in mechanically ventilated surgical trauma critically ill patients. The results showed that the accuracy of the predictive equations was limited, but among the ten equations, the modified Harris-Benedict equation was the closest to indirect calorimetry.

JOURNAL OF PARENTERAL AND ENTERAL NUTRITION (2022)

Article Nutrition & Dietetics

Energy expenditure and oxygen uptake kinetics in critically ill elderly patients

Takeshi Ebihara et al.

Summary: This study investigated the energy needs and oxygen consumption in elderly ICU patients, finding higher deviations in REE, lower D?O2, and higher oxygen extraction ratio in the elderly patients.

JOURNAL OF PARENTERAL AND ENTERAL NUTRITION (2022)

Review Nutrition & Dietetics

The effect of indirect calorimetry guided isocaloric nutrition on mortality in critically ill patients-a systematic review and meta-analysis

Barak Pertzov et al.

Summary: The study found that for critically ill patients in the ICU, isocaloric nutrition guided by IC can reduce 28-day mortality rate, but there was no significant difference in 90-day mortality rate and rate of nosocomial infections.

EUROPEAN JOURNAL OF CLINICAL NUTRITION (2022)

Article Surgery

Penn State equation versus indirect calorimetry for nutritional assessment in patients with traumatic brain injury

Sonia Wu et al.

Summary: We compared the Penn State equation and indirect calorimetry for nutritional assessment in patients with traumatic brain injury. The Penn State equation showed moderate correlation with indirect calorimetry readings, but the correlation was weaker for severe TBI. Patients received less than 50% of their nutritional requirements, especially those with severe TBI. Indirect calorimetry may be a more suitable tool for assessing nutritional needs in this population.

CANADIAN JOURNAL OF SURGERY (2022)

Article Medicine, General & Internal

Protocol summary and statistical analysis plan for Intensive Nutrition Therapy comparEd to usual care iN criTically ill adults (INTENT): a phase II randomised controlled trial

Emma J. Ridley et al.

Summary: This study aims to determine the feasibility of a whole hospital nutrition intervention in critically ill patients and whether it can deliver more total energy compared to usual care. Through a randomized controlled trial, the study will observe the impact of nutrition therapy on daily energy delivery and other related clinical outcomes.

BMJ OPEN (2022)

Review Nutrition & Dietetics

Methodological Rigor and Transparency in Clinical Practice Guidelines for Nutrition Care in Critically Ill Adults: A Systematic Review Using the AGREE II and AGREE-REX Tools

John K. Noyahr et al.

Summary: This study assessed the methodological quality of clinical practice guidelines for nutrition care in critically ill adults and the recommendations for determining energy expenditure. The findings showed that the guidelines were developed using systematic methods but lacked stakeholder engagement and specific guidance. The quality of the energy expenditure determination recommendations was low.

NUTRIENTS (2022)

Article Nutrition & Dietetics

Age-dependent differences in energy metabolism in the acute phase of critical illness

Marlene Wewalka et al.

Summary: The study aimed to evaluate whether resting energy expenditure (REE) decreases with age in critically ill medical patients and compare measured REE with energy requirements calculated by prediction equations. The results showed that REE and REEaBW decrease with age. Age and body temperature were identified as independent predictors of REE. Prediction equations underestimated energy requirements in critically ill medical patients.

NUTRITION (2022)

Article Nutrition & Dietetics

Absent Metabolic Transition from the Early to the Late Period in Non-Survivors Post Cardiac Surgery

Cecilia Veraar et al.

Summary: Longitudinal changes in resting energy expenditure, oxygen delivery, and distribution and processing may occur after major surgery. This study analyzed the pattern of these parameters in critically ill patients who died during hospitalization. The results showed that survivors experienced a transition from negative to positive energy balance, while non-survivors had decreased oxygen delivery and extraction. A lower resting energy expenditure was associated with worse survival at various time points. Non-survivors seemed to be unable to adapt metabolically from the early phase to the later phase.

NUTRIENTS (2022)

Article Nutrition & Dietetics

Measured Energy Expenditure Using Indirect Calorimetry in Post-Intensive Care Unit Hospitalized Survivors: A Comparison with Predictive Equations

Anne-Francoise Rousseau et al.

Summary: The study found that the actual energy expenditure (mEE) of ICU survivors during their post-ICU hospitalization period was around 22-23 kcal/kg/day, while the estimations from predictive equations (HB and WB) were significantly higher than the measured values. The PS equation was more accurate in estimating mEE.

NUTRIENTS (2022)

Review Endocrinology & Metabolism

Attenuating Muscle Mass Loss in Critical Illness: the Role of Nutrition and Exercise

Lee-anne S. Chapple et al.

Summary: The purpose of this review is to examine the impact of nutrition and physical activity interventions on muscle loss and recovery in critically ill patients. The findings suggest that while nutrition interventions have conflicting effects on muscle mass, they have no significant impact on strength or function. On the other hand, physical activity interventions show conflicting results, but higher levels of physical activity, especially when initiated early, appear to improve strength and function. Further research is needed to better understand the combined impact of nutrition and physical activity on muscle mass, strength, and function.

CURRENT OSTEOPOROSIS REPORTS (2022)

Article Critical Care Medicine

Core outcome measures for clinical effectiveness trials of nutritional and metabolic interventions in critical illness: an international modified Delphi consensus study evaluation (CONCISE)

T. W. Davies et al.

Summary: This study identified a core outcome set for nutritional and metabolic clinical research in critically ill adults, reaching consensus on essential domains and measurement instruments for use at 30 and 90 days post-randomisation. The CONCISE core outcome set provides internationally agreed minimum outcomes to guide future research.

CRITICAL CARE (2022)

Article Nutrition & Dietetics

Comparison of Measured Energy Expenditure Using Indirect Calorimetry vs Predictive Equations for Liver Transplant Recipients

Seok Joon Lee et al.

Summary: A study compared 4 predictive equations with indirect calorimetry to assess energy expenditure requirement for liver transplant recipients in South Korea. The results showed that all 4 equations had fixed bias in predicting resting energy expenditure, indicating the need for precise measurement using IC to avoid underestimating or overestimating metabolic needs in LT recipients.

JOURNAL OF PARENTERAL AND ENTERAL NUTRITION (2021)

Review Nutrition & Dietetics

Indirect calorimetry: The 6 main issues

Najate Achamrah et al.

Summary: Indirect calorimetry is crucial for optimizing nutritional therapy, clinicians should be aware of its indications and contraindications to interpret results and tailor nutrition plans accordingly.

CLINICAL NUTRITION (2021)

Article Nutrition & Dietetics

The effect of age and body mass index on energy expenditure of critically ill medical patients

Christin Hoelzel et al.

Summary: Background data on the influence of age and BMI on energy metabolism in critically ill patients are heterogeneous. This study found that age, BMI, and gender are independent determinants of resting energy expenditure in critically ill adults, and there are significant variations between measured and predicted energy expenditure. Prediction equations should be used with caution and repeat indirect calorimetry may not always be necessary.

EUROPEAN JOURNAL OF CLINICAL NUTRITION (2021)

Article Nutrition & Dietetics

Prolonged progressive hypermetabolism during COVID-19 hospitalization undetected by common predictive energy equations

Laura E. Niederer et al.

Summary: This study longitudinally assessed the metabolic response in critically ill COVID-19 patients, finding that indirect calorimetry measurements were more accurate in predicting metabolic demands compared to commonly used predicted equations. COVID-19 ICU patients displayed a prolonged hypermetabolic response, with differences between obese and non-obese patients.

CLINICAL NUTRITION ESPEN (2021)

Article Nutrition & Dietetics

Energy requirements of long-term ventilated COVID-19 patients with resolved SARS-CoV-2 infection

Janusz von Renesse et al.

Summary: This study evaluated the energy demands of long-term ventilated COVID-19 patients using indirect calorimetry and found poor agreement between calculated and measured resting energy expenditure. Indirect calorimetry remains the gold standard for guiding nutritional therapy in critically ill patients.

CLINICAL NUTRITION ESPEN (2021)

Article Nutrition & Dietetics

Energy expenditure and feeding practices and tolerance during the acute and late phase of critically ill COVID-19 patients

P. L. M. Lakenman et al.

Summary: This study conducted an observational study on the resting energy expenditure and feeding tolerance in critically ill COVID-19 patients. The majority of patients were found to be hypermetabolic in both acute and late phases, with enteral feeding being the common practice. Patients received hypocaloric feeding in the acute phase and almost normocaloric feeding in the late phase.

CLINICAL NUTRITION ESPEN (2021)

Article Nutrition & Dietetics

Comparison of Equations to Predict Energy Requirements With Indirect Calorimetry in Hospitalized Patients

Ana Caroline da Silva Oliveira et al.

Summary: This study evaluated the agreement between REE measured by IC and REE estimated by predictive equations in ICU patients. The IJ equation showed the greatest degree of concordance for BMI classification of underweight. Further research is needed to develop and validate tools for accurate energy expenditure measurement.

JOURNAL OF PARENTERAL AND ENTERAL NUTRITION (2021)

Article Critical Care Medicine

Association Between the Oxygen Consumption: Lactate Ratio and Survival in Critically Ill Patients With Sepsis

Anne Kirstine Hoeyer-Nielsen et al.

Summary: The VO2:lactate ratio was significantly higher in survivors, while there was no association between median VO2 alone and survival. There was a significant difference in change in VCO2 over time between survivors and non-survivors.
Article Critical Care Medicine

Nutrition management of obese critically ill adults: A survey of critical care dietitians in Australia and New Zealand

Kate J. Lambell et al.

Summary: In critically ill obese adults, ICU dietitians in Australia and New Zealand commonly rely on ESPEN guidelines for energy and protein prescription. Prospective studies are needed to further validate these findings.

AUSTRALIAN CRITICAL CARE (2021)

Letter Nutrition & Dietetics

Indirect calorimetry: A faithful guide for nutrition therapy, or a fascinating research tool?

Michael P. Casaer et al.

CLINICAL NUTRITION (2021)

Article Nutrition & Dietetics

Comparison of Energy Expenditure in Mechanically Ventilated Septic Shock Patients in Acute and Recovery Periods via Indirect Calorimetry

Elmir Israfilov et al.

Summary: The study found that energy expenditure increases in septic shock patients, but there were significant differences and no correlation between predicted resting energy expenditure, measured resting energy expenditure, and energy intake. Despite the increased energy requirement, the predicted resting energy expenditure and energy intake were lower than the measured resting energy expenditure. Monitoring and evaluating each patient's energy expenditure through intermittent indirect calorimetry measurements are important for better clinical outcomes.

JOURNAL OF PARENTERAL AND ENTERAL NUTRITION (2021)

Article Nutrition & Dietetics

Measured vs Predicted Energy Expenditure in Mechanically Ventilated Adults With Acute, Traumatic Spinal Cord Injuries

Stacy L. Pelekhaty et al.

Summary: Research on the impact of acute spinal cord injury (aSCI) on energy expenditure is limited. This study aimed to describe energy expenditure and evaluate predictive equations in mechanically ventilated adults with aSCI. Results showed that predictive equations like Penn State 2003b performed well in estimating energy expenditure, but caution should be taken to monitor for signs of overfeeding.

NUTRITION IN CLINICAL PRACTICE (2021)

Review Critical Care Medicine

Energy expenditure and indirect calorimetry in critical illness and convalescence: current evidence and practical considerations

Hanneke Pierre Franciscus Xaverius Moonen et al.

Summary: Indirect calorimetry is strongly recommended for guiding nutrition therapy in critically ill patients, but its superiority in clinical trials is not yet proven. Energy expenditure is influenced by various factors, and personalized calculation is needed for optimal nutrition support.

JOURNAL OF INTENSIVE CARE (2021)

Article Nutrition & Dietetics

Marked losses of computed tomography-derived skeletal muscle area and density over the first month of a critical illness are not associated with energy and protein delivery

Kate J. Lambell et al.

Summary: This retrospective study aimed to describe changes in computed tomography (CT)-derived skeletal muscle area (SMA) and density (SMD) across different weeks of critical illness. It found that critically ill patients experience marked losses of SMA over the first month of critical illness, with energy and protein delivery not associated with degree of muscle loss.

NUTRITION (2021)

Article Nutrition & Dietetics

Point-counterpoint: Indirect calorimetry is not necessary for optimal nutrition therapy in critical illness

Stephen A. McClave et al.

Summary: Studies have shown that in critical illness, using a simple weight-based predictive equation can provide a clinically useful approximation of energy expenditure without the need for precise measurement by IC. Providing some percentage of energy requirements achieves similar clinical benefit to full feeding in the early phases of critical illness.

NUTRITION IN CLINICAL PRACTICE (2021)

Article Endocrinology & Metabolism

Resting Energy Expenditure Early after Cardiac Surgery and Validity of Predictive Equations: A Prospective Observational Study

Huijuan Ruan et al.

Summary: The study aimed to describe the characteristics of resting energy expenditure in patients undergoing mechanical ventilation after cardiac surgery and evaluate the validity of 9 predictive equations. The 30 x BW equation was relatively acceptable for estimating REE in the early stage after heart surgery, but the IC method should be the first choice if feasible.

ANNALS OF NUTRITION AND METABOLISM (2021)

Article Critical Care Medicine

Changes in carbon dioxide production and oxygen uptake evaluated using indirect calorimetry in mechanically ventilated patients with sepsis

Ichiro Hirayama et al.

Summary: This study found that temporal changes in VCO2 and VO2, as well as their association with lactate levels, may be predictive of prognosis in patients with sepsis. Patients with negative slopes of VCO2 and VO2 changes were more likely to survive.

CRITICAL CARE (2021)

Review Critical Care Medicine

Energy delivery guided by indirect calorimetry in critically ill patients: a systematic review and meta-analysis

Jing-Yi Duan et al.

Summary: This meta-analysis found that IC-guided energy delivery significantly reduced short-term mortality in critically ill patients, without affecting the duration of mechanical ventilation, ICU stay, or hospital stay. More high-quality studies are needed to confirm these findings.

CRITICAL CARE (2021)

Article Critical Care Medicine

Is Mortality a Useful Primary End Point for Critical Care Trials?

Richard A. Veldhoen et al.

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Effects of Weight Loss on Lean Mass, Strength, Bone, and Aerobic Capacity

Edward P. Weiss et al.

MEDICINE AND SCIENCE IN SPORTS AND EXERCISE (2017)

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Optimal amount of calories for critically ill patients: Depends on how you slice the cake!

Daren K. Heyland et al.

CRITICAL CARE MEDICINE (2011)

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Oxygen transport - the oxygen delivery controversy

JL Vincent et al.

INTENSIVE CARE MEDICINE (2004)