Continuous Indirect Calorimetry in Critically Injured Patients Reveals Significant Daily Variability and Delayed,
Georgia Vasileiou1, Michelle B Mulder1, Sinong Qian1
1Miller School of Medicine, DeWitt Daughtry Family Department of Surgery, University of Miami, Miami, Florida, USA.
JPEN. Journal of Parenteral and Enteral Nutrition
|October 12, 2019
Summary
Continuous indirect calorimetry reveals resting energy expenditure (REE) fluctuates in critically injured patients, increasing over the first week. This data supports precise energy delivery for better patient outcomes.
Area of Science:
- Critical care medicine
- Metabolic research
- Nutritional support
Background:
- Previous studies relied on limited resting energy expenditure (REE) measurements, failing to capture metabolic dynamics.
- Continuous indirect calorimetry (IC) offers a more comprehensive view of metabolic needs in intensive care unit (ICU) patients.
Purpose of the Study:
- To describe the variation in REE during the initial days of ICU stay using continuous IC.
- To analyze the dynamic changes in metabolic requirements in critically injured adults.
Main Methods:
- Continuous IC was used to record REE in mechanically ventilated injured adults for up to 14 days.
- Daily REE maximum, minimum, average, and variability were calculated from steady-state measurements.
Main Results:
- Fifty-five patients were included, with a median age of 38 years; 69% were male.
- Average REE increased by 25% from admission to a peak on day 7, sustained through day 14.
- REE variability (8%-13%) was not predicted by common physiological parameters like fever or blood pressure.
Conclusions:
- Critically injured patients exhibit fluctuating REE with a gradual increase in the early post-injury period.
- Continuous REE monitoring is recommended for accurate energy delivery matching to metabolic demands in the ICU.
