Clinical Applications of Indirect Calorimetry in the Intensive Care Setting

ESPEN Guidelines on Parenteral Nutrition: Intensive care

“…Equations give only an approximate evaluation, [29][30][31] and indirect calorimetry is not available or used in many units. 32 Moreover, evidence-based studies to demonstrate the usefulness of measuring energy expenditure in the critically ill are lacking. Bartlett in 1985, 33 in a retrospective study showed that surgical ICU patients with a total energy balance lower than À10,000 kcal during their entire ICU stay, had a mortality of more that 85%.…”

The tight calorie control study (TICACOS): a prospective, randomized, controlled pilot study of nutritional support in critically ill patients

“…Factors contributing to the energy debt include the absence of feeding protocols, physical factors interfering with nutritional delivery such as impaired gastric motility, and frequent interruptions due to the presence of diarrhea or the performance of procedures, such as surgery or radiological examinations [9][10][11] as well as the inadequate assessment of ongoing and changing nutritional needs. Although energy requirements are most accurately assessed by measuring resting energy expenditure (REE) using indirect calorimetry (IC) [12], this method is not widely available or employed [13]. Instead, predictive equations like the consensus statement of the American College of Chest Physicians (ACCP) recommendation, which calculates REE as a multiple of total body weight [14], are usually used.…”

Vitamins During Cycles of Intermittent Parenteral Nutrition

“…Regarding vitamin E, it is worth pointing out that commercially available vitamin solutions are unable to maintain adequate vitamin E plasma concentrations, since they contain vitamin E isomers exerting different biologic effects and high levels of tocopherol with low biologic activity (Singer and Cohen 2003;Bartlett et al 1982).…”