Can We Rely on Predicted Basal Metabolic Rate in Patients With Intestinal Failure on Home Parenteral Nutrition?

Skallerup, Anders; Nygaard, Louis; Olesen, Søren Schou; Vinter‐Jensen, Lars; Køhler, Marianne; Rasmussen, Henrik Højgaard

doi:10.1177/0148607116657648

Cited by 12 publications

(8 citation statements)

References 28 publications

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“…– Three studies ( n = 192), mean results comparable, reported as total daily amounts (1131–1311 kcal/day) 43–45 …”

Section: Resultsmentioning

confidence: 99%

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A scoping review of parenteral requirements (macronutrients, fluid, electrolytes and micronutrients) in adults with chronic intestinal failure receiving home parenteral nutrition

Baker,

French,

Hann

et al. 2024

J Human Nutrition Diet

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IntroductionHome parenteral nutrition (HPN) prescriptions should be individualised in adults with chronic intestinal failure (IF). The aims of the review were to explore HPN requirements and available guidelines and to determine whether adults (≥ 18 years) receive recommended parenteral nutrient doses.MethodsOnline databases searches identified empirical evidence (excluding case‐reports), reviews and guidelines (Published 2006–2024 in English language). Additional reference lists were hand‐searched. Older studies, cited in national guidelines were highlighted to map evidence source. Two reviewers screened 1660 articles independently, with 98 full articles assessed and 78 articles included (of which 35 were clinical studies). Citation tracking identified 12 older studies.ResultsA lack of evidence was found assessing parenteral macronutrient (amounts and ratios to meet energy needs), fluid and electrolyte requirements. For micronutrients, 20 case series reported serum levels as biomarkers of adequacy (36 individual micronutrient levels reported). Studies reported levels below (27 out of 33) and above (24 out of 26) reference ranges for single micronutrients, with associated factors explored in 11 studies. Guidelines stated recommended parenteral dosages. Twenty‐four studies reported variable proportions of participants receiving HPN dosages outside of guideline recommendations. When associated factors were assessed, two studies showed nutrient variation with type of HPN administered (multichamber or individually compounded bags). Five studies considered pathophysiological IF classification, with patients with short bowel more likely to require individualised HPN and more fluid and sodium.ConclusionsThis review highlights substantial evidence gaps in our understanding of the parenteral nutritional requirements of adult receiving HPN. The conclusions drawn were limited by temporal bias, small samples sizes, and poor reporting of confounders and dose. Optimal HPN nutrient dose still need to be determined to aid clinical decision‐making and further research should explore characteristics influencing HPN prescribing to refine dosing recommendations.

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“…– Three studies ( n = 192), mean results comparable, reported as total daily amounts (1131–1311 kcal/day) 43–45 …”

Section: Resultsmentioning

confidence: 99%

“…Three studies measured resting energy expenditure using indirect calorimetry 43–45 . Measurement conditions were inconsistent and, although variation between measured and predicted energy expenditure was shown, different prediction equations and limits of agreement were used.…”

Section: Resultsmentioning

confidence: 99%

A scoping review of parenteral requirements (macronutrients, fluid, electrolytes and micronutrients) in adults with chronic intestinal failure receiving home parenteral nutrition

Baker,

French,

Hann

et al. 2024

J Human Nutrition Diet

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“…According to surveys and guidelines, HPN patients in general are to be surrounded by well-trained health care providers and to visit the hospital on a regular basis for the evaluation of nutritional status and possible interventions to enhance patients’ outcomes [ 8 , 18 , 48 ]. Since IF patients’ metabolisms change over time and vary in between patients [ 1 ], it is important to define REE at start-up and redefine during follow-up, particularly in long-term (>6 months) HPN patients. This allows for an individualized energy dosing plan.…”

Section: Ic From Bench To Bedsidementioning

confidence: 99%

“…Patients with a dysfunctional gastrointestinal system, for example, intestinal failure (IF), can be malnourished when the physiological demand of nutrients is higher than the nutritional intake [ 1 ]. IF is characterized by malabsorption leading to diarrhea and dehydration, making IF one of the indications for treatment with parenteral nutrition (PN) [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…The current practice often uses body weight-based calculations or equations to determine caloric goals [ 8 ]. However, the use of indirect calorimetry (IC) has a proven benefit in certain patient populations such as the critically ill [ 9 ], and in many hospitals this ‘gold standard’ has become common practice [ 1 , 10 ]. An adequate and accurate nutritional plan is necessary to meet requirements, reduce times of recovery in the acute and chronic phases and prevent complications.…”

Section: Introductionmentioning

confidence: 99%

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Energy Guidance Using Indirect Calorimetry for Intestinal Failure Patients with Home Parenteral Nutrition: The Right Bag Right at the Start

2023

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Intestinal failure is defined as the inability to absorb the minimum of macro and micronutrients, minerals and vitamins due to a reduction in gut function. In a subpopulation of patients with a dysfunctional gastrointestinal system, treatment with total or supplemental parenteral nutrition is required. The golden standard for the determination of energy expenditure is indirect calorimetry. This method enables an individualized nutritional treatment based on measurements instead of equations or body weight calculations. The possible use and advantages of this technology in a home PN setting need critical evaluation. For this narrative review, a bibliographic search is performed in PubMed and Web of Science using the following terms: ‘indirect calorimetry’, ‘home parenteral nutrition’, ‘intestinal failure’, ‘parenteral nutrition’, ‘resting energy expenditure’, ‘energy expenditure’ and ‘science implementation’. The use of IC is widely embedded in the hospital setting but more research is necessary to investigate the role of IC in a home setting and especially in IF patients. It is important that scientific output is generated in order to improve patients’ outcome and develop nutritional care paths.

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Enteral and Parenteral Nutrition: Considerations for Visceral Transplant Patients

Shah

Stroebe

2018

Psychosocial Care of End-Stage Organ Disease and Transplant Patients

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Can We Rely on Predicted Basal Metabolic Rate in Patients With Intestinal Failure on Home Parenteral Nutrition?

Abstract: The Harris-Benedict and Johnstone equations reliably predict BMR in two-thirds of clinically stable patients with IF on HPN.

Cited by 12 publications

References 28 publications

A scoping review of parenteral requirements (macronutrients, fluid, electrolytes and micronutrients) in adults with chronic intestinal failure receiving home parenteral nutrition

A scoping review of parenteral requirements (macronutrients, fluid, electrolytes and micronutrients) in adults with chronic intestinal failure receiving home parenteral nutrition

Energy Guidance Using Indirect Calorimetry for Intestinal Failure Patients with Home Parenteral Nutrition: The Right Bag Right at the Start

Enteral and Parenteral Nutrition: Considerations for Visceral Transplant Patients

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