Energy Requirements in the Post-ICU Period: An Exploratory Multicenter Observational Study

Area of Science:

• Critical Care Medicine
• Nutritional Science
• Rehabilitation Medicine

Background:

• Limited understanding of nutritional needs and energy expenditure in the post-intensive care unit (ICU) phase.
• The impact of nutritional status on clinical outcomes and physical recovery post-ICU is not well-defined.

Purpose of the Study:

• To measure energy expenditure, respiratory quotient, malnutrition risk, and body composition in post-ICU adults.
• To evaluate the effect of these parameters on energy needs, body composition, and physical rehabilitation.
• To assess nutrient provision and the impact of oral nutritional supplementation.

Main Methods:

• Observational, multicenter study involving indirect calorimetry (IC) and bioimpedance vector analysis (BIVA).
• Utilized Mini Nutritional Assessment (MNA) for malnutrition risk and PIS test for nutrient provision.
• All patients received standardized rehabilitation programs.

Main Results:

• Significant improvements in resting energy expenditure (mREE), respiratory quotient (R/Q1), and phase angle were observed from admission to discharge.
• Improved energy expenditure correlated significantly with R/Q1 and phase angle.
• No significant correlation was found between improved metabolism and PIS test scores.

Conclusions:

• Measuring energy expenditure, caloric intake, and body composition is feasible in the post-ICU period.
• These objective assessments can guide interventions to enhance functional recovery.
• The study suggests a potential, though not statistically significant, link between improved metabolism and nutritional status with shorter post-ICU stays and faster physical recovery.