A comparison between continuous indirect calorimetry and single weight-based formula in estimating resting energy expenditure in nutritional therapy: a prospective randomized controlled study in critically ill patients

Optimal nutritional therapy is important to improve outcome in critically ill population in an intensive care unit (ICU). Although indirect calorimetry (IC) is currently a gold standard for resting energy expenditure (REE) measurement, yet it is still not routinely used in the ICU. A total of...

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Main Authors: Farah Hanim A, Cheah, Saw Kian, Nadia Md Nor, Rufinah Teo, Wan Rahiza Wan Mat
Format: Article
Language:English
Published: Pusat Perubatan Universiti Kebangsaan Malaysia 2021
Online Access:http://journalarticle.ukm.my/18277/
http://journalarticle.ukm.my/18277/1/15_ms0520_pdf_12714.pdf
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author Farah Hanim A,
Cheah, Saw Kian
Nadia Md Nor,
Rufinah Teo,
Wan Rahiza Wan Mat,
author_facet Farah Hanim A,
Cheah, Saw Kian
Nadia Md Nor,
Rufinah Teo,
Wan Rahiza Wan Mat,
author_sort Farah Hanim A,
building UKM Institutional Repository
collection Online Access
description Optimal nutritional therapy is important to improve outcome in critically ill population in an intensive care unit (ICU). Although indirect calorimetry (IC) is currently a gold standard for resting energy expenditure (REE) measurement, yet it is still not routinely used in the ICU. A total of 146 mechanically ventilated patients were randomised to receive enteral nutrition (EN) with energy targeted based on continuous indirect calorimetry (IC) measurements (IC group, n=73) or according to 25 kcal/kg/day (SWB group, n=73). Patient characteristics were equally distributed and the IC group showed lower mean measured REE (1668.1 + 231.7 vs 1512.0 + 177.1 kcal, p<0.001). Results also showed a significant deficiency in the daily (-148.8 + 105.1 vs. -4.99 + 44.0 kcal, p<0.001) and total cumulative energy balances (-1165.3 + 958.1 vs. 46.5 + 369.5 kcal, p<0.001) in the SWB group as compared to the IC group. From the Kaplan-Meier survival analysis, we found that ICU mortality was significantly lower in the IC group with better survival probability compared to the SWB group (log-rank test, p = 0.03). However, both groups showed comparable results in terms of ICU length of stay, duration of mechanical ventilation and incidence of feeding intolerance. In conclusion, this study showed that tightly supervised nutritional therapy based on continuous IC measurement provides significantly less mean daily and cumulative energy deficits as well as significantly reduced ICU mortality rate.
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spelling oai:generic.eprints.org:182772022-03-25T01:51:36Z http://journalarticle.ukm.my/18277/ A comparison between continuous indirect calorimetry and single weight-based formula in estimating resting energy expenditure in nutritional therapy: a prospective randomized controlled study in critically ill patients Farah Hanim A, Cheah, Saw Kian Nadia Md Nor, Rufinah Teo, Wan Rahiza Wan Mat, Optimal nutritional therapy is important to improve outcome in critically ill population in an intensive care unit (ICU). Although indirect calorimetry (IC) is currently a gold standard for resting energy expenditure (REE) measurement, yet it is still not routinely used in the ICU. A total of 146 mechanically ventilated patients were randomised to receive enteral nutrition (EN) with energy targeted based on continuous indirect calorimetry (IC) measurements (IC group, n=73) or according to 25 kcal/kg/day (SWB group, n=73). Patient characteristics were equally distributed and the IC group showed lower mean measured REE (1668.1 + 231.7 vs 1512.0 + 177.1 kcal, p<0.001). Results also showed a significant deficiency in the daily (-148.8 + 105.1 vs. -4.99 + 44.0 kcal, p<0.001) and total cumulative energy balances (-1165.3 + 958.1 vs. 46.5 + 369.5 kcal, p<0.001) in the SWB group as compared to the IC group. From the Kaplan-Meier survival analysis, we found that ICU mortality was significantly lower in the IC group with better survival probability compared to the SWB group (log-rank test, p = 0.03). However, both groups showed comparable results in terms of ICU length of stay, duration of mechanical ventilation and incidence of feeding intolerance. In conclusion, this study showed that tightly supervised nutritional therapy based on continuous IC measurement provides significantly less mean daily and cumulative energy deficits as well as significantly reduced ICU mortality rate. Pusat Perubatan Universiti Kebangsaan Malaysia 2021-12 Article PeerReviewed application/pdf en http://journalarticle.ukm.my/18277/1/15_ms0520_pdf_12714.pdf Farah Hanim A, and Cheah, Saw Kian and Nadia Md Nor, and Rufinah Teo, and Wan Rahiza Wan Mat, (2021) A comparison between continuous indirect calorimetry and single weight-based formula in estimating resting energy expenditure in nutritional therapy: a prospective randomized controlled study in critically ill patients. Medicine & Health, 16 (2). pp. 207-215. ISSN 2289-5728 https://medicineandhealthukm.com/toc/16/2
spellingShingle Farah Hanim A,
Cheah, Saw Kian
Nadia Md Nor,
Rufinah Teo,
Wan Rahiza Wan Mat,
A comparison between continuous indirect calorimetry and single weight-based formula in estimating resting energy expenditure in nutritional therapy: a prospective randomized controlled study in critically ill patients
title A comparison between continuous indirect calorimetry and single weight-based formula in estimating resting energy expenditure in nutritional therapy: a prospective randomized controlled study in critically ill patients
title_full A comparison between continuous indirect calorimetry and single weight-based formula in estimating resting energy expenditure in nutritional therapy: a prospective randomized controlled study in critically ill patients
title_fullStr A comparison between continuous indirect calorimetry and single weight-based formula in estimating resting energy expenditure in nutritional therapy: a prospective randomized controlled study in critically ill patients
title_full_unstemmed A comparison between continuous indirect calorimetry and single weight-based formula in estimating resting energy expenditure in nutritional therapy: a prospective randomized controlled study in critically ill patients
title_short A comparison between continuous indirect calorimetry and single weight-based formula in estimating resting energy expenditure in nutritional therapy: a prospective randomized controlled study in critically ill patients
title_sort comparison between continuous indirect calorimetry and single weight-based formula in estimating resting energy expenditure in nutritional therapy: a prospective randomized controlled study in critically ill patients
url http://journalarticle.ukm.my/18277/
http://journalarticle.ukm.my/18277/
http://journalarticle.ukm.my/18277/1/15_ms0520_pdf_12714.pdf