The performance of a variable-flow indirect calorimeter

Indirect calorimetry estimates energy expenditure from measurement of respiratory gas exchange volumes. This paper considers the design and evaluation of an indirect calorimeter, the Europa GEM, suitable for use in nutritional research. The calorimeter is of the ventilated hood, flow-through type and is intended for use with spontaneously breathing patients. Our aim was to develop an accurate, flexible instrument with a high level of automation. Performance was assessed in a laboratory simulation using reference gas injections (n = 24) producing a mean error of 0.3 +/- 2% in oxygen consumption (VO2), 1.8 +/- 1% in carbon dioxide production (VCO2) and 1.4 +/- 1.5% in respiratory quotient (RQ). In order to investigate the effect of FeCO2 on error multiplication a further subdivision (n = 8) of tests at FeCO2 = 0.5%, 0.75% and 1% was made by modulating the air flow through the hood. However, the predicted increase in system accuracy with increasing FeCO2 was not apparent in practice.