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Related Experiment Videos

Hypocaloric feeding: pros and cons.

Mette M Berger1, René L Chioléro

  • 1Department of Adult Intensive Care Medicine & Burns Centre, University Hospital (CHUV), Lausanne, Switzerland. Mette.Berger@chuv.ch

Current Opinion in Critical Care
|March 1, 2007
PubMed
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Hypocaloric feeding in critically ill patients lacks definition and evidence. Negative energy balance correlates with poor outcomes, suggesting hypocaloric feeding is not supported by current evidence.

Area of Science:

  • Critical Care Medicine
  • Nutritional Support
  • Metabolic Monitoring

Background:

  • Hypocaloric feeding is frequently suggested for critically ill patients but lacks a clear definition and evidence base.
  • Accurate determination of energy requirements is crucial to avoid detrimental overfeeding or underfeeding.

Purpose of the Study:

  • To define hypocaloric feeding using indirect calorimetry data.
  • To review clinical outcomes associated with hypocaloric feeding in critically ill patients.

Main Methods:

  • Indirect calorimetry as the precise method for determining resting energy expenditure (REE).
  • Defining feeding strategies: hypocaloric (0.5-0.9 REE), isocaloric (1.1-1.3 REE), and hypercaloric (>1.5 REE).
  • Evaluating the accuracy of predictive equations for energy requirements.

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Main Results:

  • Predictive equations for energy requirements are inaccurate in over 30% of patients, regardless of body composition.
  • Indirect calorimetry is the most accurate method for determining energy needs in clinical settings.
  • Defined feeding ranges: hypocaloric (0.5-0.9 REE), isocaloric (1.1-1.3 REE), hypercaloric (>1.5 REE).

Conclusions:

  • Negative energy balance is linked to adverse outcomes in intensive care unit and hospital settings.
  • Current evidence does not support the use of hypocaloric feeding in critically ill patients.
  • Further prospective trials are needed to define feeding tolerance thresholds.