Do We Need Different Predictive Equations for the Acute and Late Phases of Critical Illness? A Prospective Observational Study with Repeated Indirect Calorimetry Measurements

Overview

Journal Eur J Clin Nutr

Specialty Nutritional Sciences

Date 2021 Aug 31

PMID 34462560

Citations 2

Authors

Pei Chien Tah

Bee Koon Poh

Chee Cheong Kee

Zheng-Yii Lee

Vineya-Rai Hakumat-Rai

Mohd Basri Mat Nor

Mazuin Kamarul Zaman

Hazreen Abdul Majid

M Shahnaz Hasan

Affiliations

Soon will be listed here.

Abstract

Background: Predictive equations (PEs) for estimating resting energy expenditure (REE) that have been developed from acute phase data may not be applicable in the late phase and vice versa. This study aimed to assess whether separate PEs are needed for acute and late phases of critical illness and to develop and validate PE(s) based on the results of this assessment.

Methods: Using indirect calorimetry, REE was measured at acute (≤5 days; n = 294) and late (≥6 days; n = 180) phases of intensive care unit admission. PEs were developed by multiple linear regression. A multi-fold cross-validation approach was used to validate the PEs. The best PEs were selected based on the highest coefficient of determination (R), the lowest root mean square error (RMSE) and the lowest standard error of estimate (SEE). Two PEs developed from paired 168-patient data were compared with measured REE using mean absolute percentage difference.

Results: Mean absolute percentage difference between predicted and measured REE was <20%, which is not clinically significant. Thus, a single PE was developed and validated from data of the larger sample size measured in the acute phase. The best PE for REE (kcal/day) was 891.6(Height) + 9.0(Weight) + 39.7(Minute Ventilation)-5.6(Age) - 354, with R = 0.442, RMSE = 348.3, SEE = 325.6 and mean absolute percentage difference with measured REE was: 15.1 ± 14.2% [acute], 15.0 ± 13.1% [late].

Conclusions: Separate PEs for acute and late phases may not be necessary. Thus, we have developed and validated a PE from acute phase data and demonstrated that it can provide optimal estimates of REE for patients in both acute and late phases.

Trial Registration: ClinicalTrials.gov NCT03319329.

Citing Articles

[Correlation of equations for energy expenditure with indirect calorimetry in critically ill patients].

Lopez-Villegas A, Gomez-Gonzalez M, Gonzalez-Carrillo P Rev Med Inst Mex Seguro Soc. 2023; 61(Suppl 2):S246-S253.

PMID: 38016112 PMC: 11513400.

External validation of BIA equations to estimate appendicular skeletal muscle mass in older adults: Importance of the bias analysis and derivation of correction factors to achieve agreement.

Canez-Rios M, Esparza-Romero J, Gonzalez-Arellanes R, Ramirez-Torres M, Figueroa-Pesqueira G, Urquidez-Romero R Front Nutr. 2022; 9:951346.

PMID: 36091228 PMC: 9454307. DOI: 10.3389/fnut.2022.951346.

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