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Original research
Throwing darts in ICU: how close are we in estimating energy requirements?
  1. Laryssa Grguric1,
  2. Lisa Musillo2,
  3. Jody C DiGiacomo3,
  4. Swapna Munnangi3
  1. 1Infusion Nutritional Support, Coram CVS Specialty Infusion Services, Miramar, Florida, USA
  2. 2Food and Nutrition, Nassau University Medical Center, East Meadow, New York, USA
  3. 3Surgery, Nassau University Medical Center, East Meadow, New York, USA
  1. Correspondence to Dr Jody C DiGiacomo, Department of Surgery, Nassau University Medical Center, East Meadow, NY 11554, USA; jdigiac1{at}numc.edu

Abstract

Background Indirect calorimetry (IC) is the gold standard for determining energy requirement. Due to lack of availability in many institutions, predictive equations are used to estimate energy requirements. The purpose of this study is to determine the accuracy of predictive equations (ie, Harris-Benedict equation (HBE), Mifflin-St Jeor equation (MSJ), and Penn State University equation (PSU)) used to determine energy needs for critically ill, ventilated patients compared with measured resting energy expenditure (mREE).

Methods The researchers examined data routinely collected as part of clinical care for patients within intensive care units (ICUs). The final sample consisted of 68 patients. All studies were recorded during a single inpatient stay within an ICU.

Results Patients, on average, had an mREE of 33.9 kcal/kg using IC. The estimated energy requirement when using predictive equations was 24.8 kcal/kg (HBE×1.25), 24.0 kcal/kg (MSJ×1.25), and 26.8 kcal/kg (PSU).

Discussion This study identified significant differences between mREE and commonly used predictive equations in the ICU.

Level of evidence III.

  • intensive care units
  • nutritional sciences
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/tsaco-2020-000493

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    Footnotes

    • Contributors LG, LM, and JCD: conception and design, interpretation, and reporting. LG and LM: data collection. SM: statistical analysis.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study was approved by the Nassau University Medical Center Institutional Review Board (protocol number 17-167) on November 1, 2017. Consent was waived as this is a retrospective review.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Deidentified participant data are available with permission from the corresponding author.