RT Journal
A1 Cortes V, Nelson LD
T1 ERrors in estimating energy expenditure in critically ill surgical patients
JF Archives of Surgery
JO Archives of Surgery
YR 1989
FD March 1
VO 124
IS 3
SP 287
OP 290
DO 10.1001/archsurg.1989.01410030033005
UL http://dx.doi.org/10.1001/archsurg.1989.01410030033005
AB • Thirty-one critically ill surgical patients were receiving central parenteral nutrition. All were intubated, and 29 were receiving mechanical ventilatory support. Nutritional and metabolic data were recorded at the time of indirect calorimetry. Measured energy expenditure (MEE) was compared with predictions of basal energy expenditure (BEE) and calculated energy expenditure, defined as the product of BEE and a stress factor estimated by the nutrition support service to account for severity of illness and activity. The MEE was significantly greater than the BEE and significantly less than the calculated energy expenditure. The estimated stress factor was significantly greater than the actual MEE/BEE ratio, and the correlation between these values was poor. Clinical assessment may overestimate energy expenditure in critically ill patients because of the apparent degree of illness used to determine the stress factor. Bedside indirect calorimetry may be useful to assess more accurately energy expenditure and optimize nutritional support.(Arch Surg 1989;124:287-290)