Mechanically Ventilated, Cardiothoracic Surgical Patients Have Significantly Different Energy Requirements Comparing Indirect Calorimetry and the Penn State Equations
| Autor: | Robert Ratzlaff, Edward J. Mascha, J. Steven Hata, Kevin Faulhaber, Desiree Gordillo, Diane Nowak, Gail A. Cresci |
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| Rok vydání: | 2016 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty Calorie Critical Illness Nutritional Status Medicine (miscellaneous) Calorimetry Energy requirement law.invention 03 medical and health sciences 0302 clinical medicine law Maximum difference medicine Humans 030212 general & internal medicine Aged Retrospective Studies Postoperative Care 030109 nutrition & dietetics Nutrition and Dietetics business.industry Malnutrition Nutritional Requirements Calorimetry Indirect Retrospective cohort study Middle Aged Respiration Artificial Intensive care unit Confidence interval Surgery Intensive Care Units Cardiovascular Diseases Anesthesia Female Basal Metabolism business Surgical patients |
| Zdroj: | Journal of Parenteral and Enteral Nutrition. 40:959-965 |
| ISSN: | 1941-2444 0148-6071 |
| Popis: | Nutrition equations have been validated with indirect calorimetry for determining energy needs in intensive care unit (ICU) populations. This study tested the hypothesis that mechanically ventilated cardiothoracic surgical patients would have significantly different energy requirements when determined by indirect calorimetry vs the Penn State equations.This single-center, retrospective cohort analysis of consecutive cardiothoracic surgical patients adhered to a prospectively designed protocol for indirect calorimetry energy measurements. Energy needs were estimated by Penn State equations 2010 and 2003b and then indirect calorimetry.Analyzed patients (n = 71) had a mean ± SD difference of 556 ± 543 calories/d between indirect calorimetry and Penn State formulae, as well as a mean ± SD percentage caloric difference of 32% ± 31% (95% confidence interval [CI], -20 to 87) with a range of 1311 calories (minimum difference, -379; maximum difference, 933). There was a 10% or greater difference in resting metabolic rate between indirect calorimetry and the Penn State equations in 89% of patients (95% CI, 79%-95%). Based on Lin's concordance correlation of 0.20 (95% CI, 0.09-0.32), the strength of agreement between the resting metabolic rates determined by indirect calorimetry compared with the Penn State equations was poor within this patient sample. Indirect calorimetry performance showed a 10% increase in caloric need in 77% of patients and was associated with a nutrition prescription change in 66%.Mechanically ventilated cardiothoracic surgical ICU patients appear to have higher energy requirements by indirect calorimetry than those determined by Penn State equations. Future studies targeting indirect calorimetry in relation to clinical outcomes are needed. |
| Databáze: | OpenAIRE |
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