Accuracy of an indirect calorimeter for mechanically ventilated infants and children: The influence of low rates of gas exchange and varying Fio2

Joosten, Koen; Jacobs, Frans I.; Klaarwater, Erik van; Baartmans, Martin; Hop, Wim C. J.; Meriläinen, Pekka; Hazelzet, Jan A.

doi:10.1097/00003246-200008000-00056

Cited by 21 publications

(15 citation statements)

References 16 publications

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“…The Deltatrac is an open-system indirect calorimetry device. This metabolic monitor has been widely validated and tested for accuracy and reproducibility in vitro and in vivo (3,35), which enables its clinical use in the PICU. It measuresVO 2 andVCO 2 from gas exchange measurements and calculates the MEE and respiratory quotient.…”

Section: Methodsmentioning

confidence: 99%

Predicted versus measured energy expenditure by continuous, online indirect calorimetry in ventilated, critically ill children during the early postinjury period*

Martínez¹,

Martínez-Romillo²,

Sebastián³

et al. 2004

Pediatric Critical Care Medicine

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Section: Methodsmentioning

confidence: 99%

Predicted versus measured energy expenditure by continuous, online indirect calorimetry in ventilated, critically ill children during the early postinjury period*

Martínez¹,

Martínez-Romillo²,

Sebastián³

et al. 2004

Pediatric Critical Care Medicine

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“…Oxygen consumption, carbon dioxide production, and RQ standardized for temperature, barometric pressure, and humidity were measured with the Deltatrac II MBM-200 (Datex Division Instrumentarium, Helsinki, Finland) metabolic monitor, and MEE was calculated with the modified Weir's formula [13]. The properties of the Deltatrac metabolic monitor have been described previously [14]. Before each study, the calorimeter was calibrated with a reference gas mixture (95% O 2 , 5% CO 2 ; Datex Division Instrumentarium).…”

Section: Energy Expenditurementioning

confidence: 99%

Adequate feeding and the usefulness of the respiratory quotient in critically ill children

et al. 2005

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Objective: We determined incidences of underfeeding and overfeeding in children who were admitted to a multidisciplinary tertiary pediatric intensive care and evaluated the usefulness of the respiratory quotient (RQ) obtained from indirect calorimetry to assess feeding adequacy.Methods: Children 18 y and younger who fulfilled the criteria for indirect calorimetry entered our prospective, observational study and were studied until day 14. Actual energy intake was recorded, compared with required energy intake (measured energy expenditure plus 10%), and classified as underfeeding (Ͻ90% of required), adequate feeding (90% to 110% of required), or overfeeding (Ͼ110% of required). We also evaluated the adequacy of a measured RQ lower than 0.85 to identify underfeeding, and an RQ higher than 1.0 to identify overfeeding. Results: Ninety-eight children underwent 195 calorimetric measurements. Underfeeding, adequate feeding, and overfeeding occurred on 21%, 10%, and 69% of days, respectively. An RQ lower than 0.85 to identify underfeeding showed low sensitivity (63%), high specificity (89%), and high negative predictive value (90%). An RQ higher than 1.0 to indicate overfeeding showed poor sensitivity (21%), but a high specificity (97%) and a high positive predictive value (93%). Food composition, notably high-carbohydrate intake, was responsible for an RQ exceeding 1.0 in the overfed group. Conclusion: Children admitted to the intensive care unit receive adequate feeding on only 10% of measurement days during the first 2 wk of admission. The usefulness of RQ to monitor feeding adequacy is limited to identifying (carbohydrate) overfeeding and excluding underfeeding.

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“…General use, however, is not recommended because of lack of data on outcome and the need for special equipment which is necessary to perform the measurements. Metabolic monitors may not be available because of high costs and their use may be limited in mechanically ventilated patients with a high level of inspired oxygen and more than 10% tube leakage [25 , 26,27].…”

Section: Estimation Of Nutritional Needsmentioning

confidence: 99%

Causes and consequences of inadequate substrate supply to pediatric ICU patients

Hulst

Joosten

Tibboel

et al. 2006

Current Opinion in Clinical Nutrition and Metabolic Care

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In the majority of children admitted to a pediatric intensive care unit, nutritional problems--both underfeeding and overfeeding--occur during admission due to poor estimation of nutritional needs, under-prescribing and problems in the delivery of the nutrients. Recommendations are made in order to prevent inadequate nutritional supply and its potentially harmful consequences in critically ill children.

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Accuracy of an indirect calorimeter for mechanically ventilated infants and children: The influence of low rates of gas exchange and varying Fio2

Cited by 21 publications

References 16 publications

Predicted versus measured energy expenditure by continuous, online indirect calorimetry in ventilated, critically ill children during the early postinjury period*

Predicted versus measured energy expenditure by continuous, online indirect calorimetry in ventilated, critically ill children during the early postinjury period*

Adequate feeding and the usefulness of the respiratory quotient in critically ill children

Causes and consequences of inadequate substrate supply to pediatric ICU patients

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