The nutritional status affects the factors of patient outcome such as the therapeutic intervention, the length of hospitalization and prognosis. Personalization of nutritional support treatments can minimize the complications that may arise from overfeeding and underfeeding. Appropriate nutritional support requires an individual nutrition assessment based on each patient's caloric and regularly monitored respiratory quotient to accommodate continuing changes in the patient's condition.
Basal Metabolism ; Calorimetry, Indirect ; methods ; Energy Intake ; Humans ; Nutrition Assessment ; Nutritional Requirements ; Nutritional Status

During the management of critical illness, optimal nutritional support is an important key for achieving positive clinical outcomes. Compared to healthy people, critically ill patients have higher energy expenditure, thereby their energy requirements and risk of malnutrition being increased. Assessing individual nutritional requirement is essential for a successful nutritional support, including the adequate energy supply. Methods to assess energy requirements include indirect calorimetry (IC) which is considered as a reference method, and the predictive equations which are commonly used due to the difficulty of using IC in certain conditions. In this study, a literature review was conducted on the energy metabolic changes in critically ill patients, and the implications for the estimation of energy requirements in this population. In addition, the issue of optimal caloric goal during nutrition support is discussed, as well as the accuracy of selected resting energy expenditure predictive equations, commonly used in critically ill patients.
Calorimetry, Indirect ; Critical Illness* ; Energy Metabolism ; Humans ; Malnutrition ; Methods ; Nutritional Requirements ; Nutritional Support

BACKGROUND/OBJECTIVES: Indirect calorimetry is the gold-standard method for the measurement of resting energy expenditure. However, this method is time consuming, expensive, and requires highly trained personnel. To overcome these limitations, various predictive equations have been developed. The objective of this study was to assess the validity of predictive equations for resting energy expenditure (REE) in Korean non-obese adults. SUBJECTS/METHODS: The present study involved 109 participants (54 men and 55 women) aged between 20 and 64 years. The REE was measured by indirect calorimetry. Nineteen REE equations were evaluated for validity, by comparing predicted and measured REE results. Predictive equation accuracy was assessed by determining percent bias, root mean squared prediction error (RMSE), and percentage of accurate predictions. RESULTS: The measured REE was significantly higher in men than in women (P < 0.001), but the difference was not significant after adjusting for body weight (P > 0.05). The equation developed in this study had an accuracy rate of 71%, a bias of 0%, and an RMSE of 155 kcal/day. Among published equations, the FAO(weight) equation gave the highest accuracy rate (70%), along with a bias of −4.4% and an RMSE of 184 kcal/day. CONCLUSIONS: The newly developed equation provided the best accuracy in predicting REE for Korean non-obese adults. Among the previously published equations, the FAO(weight) equation showed the highest overall accuracy. Regardless, at an individual level, the equations could lead to inaccuracies in a considerable number of subjects.
Adult* ; Bias (Epidemiology) ; Body Weight ; Calorimetry, Indirect ; Energy Metabolism* ; Female ; Humans ; Male ; Methods

Objective: To compare the differences to determine resting energy expenditure (REE) measured with indirect calorimetry and REE predicted by formula method and body composition analyzer in patients with decompensated hepatitis B cirrhosis, so as to provide theoretical guidance for the implementation of precision nutrition intervention. Methods: Patients with decompensated hepatitis B cirrhosis who were admitted to Henan Provincial People's Hospital from April 2020 to December 2020 were collected. REE was determined by the body composition analyzer and the H-B formula method. Results: were analyzed and compared to REE measured by the metabolic cart. Results A total of 57 cases with liver cirrhosis were included in this study. Among them, 42 were male, aged (47.93 ± 8.62) years, and 15 were female aged (57.20 ± 11.34) years. REE measured value in males was (1 808.14 ± 201.47) kcal/d, compared with the results calculated by the H-B formula method and the measured result of body composition, and the difference was statistically significant (P = 0.002 and 0.003, respectively). REE measured value in females was (1 496.60 ± 131.28) kcal/d, compared with the results calculated by the H-B formula method and the measured result of body composition, and the difference was statistically significant (P = 0.016 and 0.004, respectively). REE measured with the metabolic cart had correlation with age and area of visceral fat in men (P = 0.021) and women (P = 0.037). Conclusion: Metabolic cart use will be more accurate to obtain resting energy expenditure in patients with decompensated hepatitis B cirrhosis. Body composition analyzer and formula method may underestimate REE predictions. Simultaneously, it is suggested that the effect of age on REE in H-B formula should be fully considered for male patients, while the area of visceral fat may have a certain impact on the interpretation of REE in female patients.
Humans ; Male ; Female ; Energy Metabolism ; Liver Cirrhosis/metabolism* ; Calorimetry, Indirect/methods* ; Hospitalization

OBJECTIVETo establish the value of the resting energy expenditure (REE) in healthy newborns and evaluate relative factors of REE.

METHODSOne hundred and fifty-four healthy newborns (75 boys, 79 girls; birth-weight 2,500-3,999 g) were enrolled in this study. The Apgar score at the 5th minute was equal to or more than 8; the postnatal age was equal to or more than 5 days. The newborns had no apparent defect. The mothers had no history of metabolic and endocrine diseases. REE was measured by Deltatrac II in child canopy mode for 30-45 minutes during asleep or quiet awake status.

RESULTSThe average REE was (201.8 +/- 25.4) kJ/(kg.d), which was significantly lower than the predicted REE by Schofield formula[(226.1 +/- 4.8) kJ/(kg.d), P = 0.000], the predicted REE was 12.04% higher than the measured REE. There were no differences in sex and ways of delivery. The newborns whose birth-weight was between 2,500-2,999 g were measured in two modes: baby and child mode, and the REE values were significantly higher (122.6 +/- 25.0) kJ/(kg.d) and (208.8 +/- 26.4) kJ/(kg.d), respectively (P = 0.000).

CONCLUSIONSThe prediction formula might be improper for calculating the REE in newborn infants. The indirect calorimetry was the better way to know the actual REE of newborns. The authors recommended that in child mode the measurement of REE in newborns would be the indirect calorimetry, and the REE in healthy newborns was (201.8 +/- 25.4) kJ/(kg.d).

Birth Weight ; Calorimetry, Indirect ; methods ; Delivery, Obstetric ; methods ; Energy Metabolism ; physiology ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Male ; Sex Factors

PURPOSE: Equations are frequently used to estimate resting energy expenditure (REE) in a clinical setting. However, few studies have examined their accuracy in end-stage renal disease (ESRD) patients. PATIENTS AND METHODS: To investigate agreement between indirect calorimetry and several REE estimating equations in 38 ESRD patients on peritoneal dialysis, we performed indirect calorimetry and compared the results with REEs estimated using 5 equations [Harris-Benedict (HBE), Mifflin, WHO, Schofield, and Cunningham]. RESULTS: Measured REE was 1393.2 +/- 238.7kcal/day. There were no significant differences between measured and estimated REEs except Mifflin (1264.9 +/- 224.8kcal/day). Root mean square errors were smallest for HBE, followed by Schofield, Cunningham, and WHO, and largest for Mifflin (171.3, 171.9, 174.6, 175.3, and 224.6, respectively). In Bland-Altman plot, correlation coefficients between mean values and differences were significant for HBE (r=0.412, p=0.012) and tended to be significant for Cunningham (r=0.283, p=0.086). In DM patients and patients with overhydration, HBE showed significant underestimation when REE increased. CONCLUSION: In ESRD patients on continuous ambulatory peritoneal dialysis (CAPD), REE-estimating equations have no significant differences from indirect calorimetry, except Mifflin. However, HBE showed greater bias than others when REE was high.
Adolescent ; Adult ; Calorimetry, Indirect/*methods ; *Energy Metabolism ; Female ; Humans ; Kidney Failure, Chronic/metabolism/*therapy ; Male ; Middle Aged ; Models, Biological ; Peritoneal Dialysis, Continuous Ambulatory/*methods