Retrospective Evaluation of Commonly Used Equations to Predict Energy Expenditure in Mechanically Ventilated, Critically Ill Patients

Alexander, Earnest; Susla, Gregory M.; Burstein, Aaron H.; Brown, Dennis T.; Ognibene, Frederick P.

doi:10.1592/phco.24.17.1659.52342

Cited by 34 publications

(25 citation statements)

References 19 publications

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“…The choice for calculating resting energy expenditure (REE) as Harris-Benedict times 1.2 originates from the recommendation by Alexander and colleagues [9] where actual REE are compared with formulas used in the ICU. Also the AARC guidelines uses the Harris-Benedict equation.…”

Section: Methodsmentioning

confidence: 99%

Optimal nutrition during the period of mechanical ventilation decreases mortality in critically ill, long-term acute female patients: a prospective observational cohort study

et al. 2009

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Introduction Optimal nutrition for intensive care patients has been proposed to be the provision of energy as determined by indirect calorimetry, and protein provision of at least 1.2 g/kg pre-admission weight per day. The evidence supporting these nutritional goals is based on surrogate outcomes and is not yet substantiated by patient oriented, clinically meaningful endpoints. In the present study we evaluated the effects of achieving optimal nutrition in ICU patients during their period of mechanical ventilation on mortality.

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Section: Methodsmentioning

confidence: 99%

Optimal nutrition during the period of mechanical ventilation decreases mortality in critically ill, long-term acute female patients: a prospective observational cohort study

et al. 2009

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“…For nonobese patients, the Harris-Benedict equation, multiplied by a stress factor of 1.3–1.5 reasonably estimates energy expenditure and therefore, caloric needs in critically ill patients. 19 Nevertheless, this and other estimates may be inaccurate and individual patients may benefit from indirect calorimetry as discussed subsequently. Assessing the patient’s preinjury nutritional and general health status is often difficult and frequently impossible, at least initially.…”

Section: Caloric Requirements and Nutrient Formulationmentioning

confidence: 99%

Inflammation and the Host Response to Injury, a Large-Scale Collaborative Project: Patient-Oriented Research Core—Standard Operating Procedures for Clinical Care VIII—Nutritional Support of the Trauma Patient

O’Keefe

Shelton

Cuschieri

et al. 2008

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…(20,30) However, the results of other authors indicate that the HB equation in an acceptable substitute for IC. (31,32) The latest ESPEN guidelines (8) recommend that, in the absence of IC, the critically ill patient should receive 25 kcal/kg per day and that this value should reached over 2 to 3 days after the beginning of NS. By verifying the average energy requirements of 24.48 kcal/kg/day, our results indicated that overall, the value that is recommended by the European society is suitable for the overall requirement of patients in this ICU, although a slight hyperalimentation may occur, particularly in obese individuals.…”

Section: Discussionmentioning

confidence: 99%

Necessidades nutricionais do doente crítico

Costa¹,

Marinho²,

Cançado³

2012

Rev. bras. ter. intensiva

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Objective: Given the inaccessibility of indirect calorimetry, intensive care units generally use predictive equations or recommendations that are established by international societies to determine energy expenditure. The aim of the present study was to compare the energy expenditure of critically ill patients, as determined using indirect calorimetry, to the values obtained using the Harris-Benedict equation.Methods: A retrospective observational study was conducted at the Intensive Care Unit 1 of the Centro Hospitalar do Porto. The energy requirements of hospitalized critically ill patients as determined using indirect calorimetry were assessed between January 2003 and April 2012. The accuracy (± 10% difference between the measured and estimated values), the mean differences and the limits of agreement were determined for the studied equations.Results: Eighty-five patients were assessed using 288 indirect calorimetry measurements. The following energy requirement values were obtained for the different methods: 1,753.98±391.13 kcal/ day (24.48 ± 5.95 kcal/kg/day) for indirect calorimetry and 1,504.11 ± 266.99 kcal/day (20.72±2.43 kcal/kg/day) for the HarrisBenedict equation. The equation had a precision of 31.76% with a mean difference of -259.86 kcal/day and limits of agreement between -858.84 and 339.12 kcal/day. Sex (p=0.023), temperature (p=0.009) and body mass index (p<0.001) were found to significantly affect energy expenditure.Conclusion: The Harris-Benedict equation is inaccurate and tends to underestimate energy expenditure. In addition, the Harris-Benedict equation is associated with significant differences between the predicted and true energy expenditure at an individual level.

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Retrospective Evaluation of Commonly Used Equations to Predict Energy Expenditure in Mechanically Ventilated, Critically Ill Patients

Abstract: The Harris-Benedict equation multiplied by an activity factor of 1.2 is suitable for predicting REE and may be used in the absence of indirect calorimetry.

Cited by 34 publications

References 19 publications

Optimal nutrition during the period of mechanical ventilation decreases mortality in critically ill, long-term acute female patients: a prospective observational cohort study

Optimal nutrition during the period of mechanical ventilation decreases mortality in critically ill, long-term acute female patients: a prospective observational cohort study

Inflammation and the Host Response to Injury, a Large-Scale Collaborative Project: Patient-Oriented Research Core—Standard Operating Procedures for Clinical Care VIII—Nutritional Support of the Trauma Patient

Necessidades nutricionais do doente crítico

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