Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Determining the appropriate resting energy expenditure requirement for severe trauma patients using indirect calorimetry in Korea: a retrospective observational study

  • Hak-Jae Lee (Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sung-Bak Ahn (Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jung Hyun Lee (Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ji-Yeon Kim (Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sungyeon Yoo (Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Suk-Kyung Hong (Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2023.07.27
  • Accepted : 2023.09.05
  • Published : 2023.12.31
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Abstract

Purpose: This study aimed to compare the resting energy expenditure (REE) measured using indirect calorimetry with that estimated using predictive equations in severe trauma patients to determine the appropriate caloric requirements. Methods: Patients admitted to the surgical intensive care unit between January 2020 and March 2023 were included in this study. Indirect calorimetry was used to measure the patients' REE values. These values were subsequently compared with those estimated using predictive equations: the weight-based equation (rule of thumb, 25 kcal/kg/day), Harris-Benedict, Ireton-Jones, and the Penn State 2003 equations. Results: A total of 27 severe trauma patients were included in this study, and 47 indirect calorimetric measurements were conducted. The weight-based equation (mean difference [MD], -28.96±303.58 kcal) and the Penn State 2003 equation (MD, - 3.56±270.39 kcal) showed the closest results to REE measured by indirect calorimetry. However, the REE values estimated using the Harris-Benedict equation (MD, 156.64±276.54 kcal) and Ireton-Jones equation (MD, 250.87±332.54 kcal) displayed significant differences from those measured using indirect calorimetry. The concordance rate, which the predictive REE differs from the measured REE value within 10%, was up to 36.2%. Conclusions: The REE values estimated using predictive equations exhibited substantial differences from those measured via indirect calorimetry. Therefore, it is necessary to measure the REE value through indirect calorimetry in severe trauma patients.

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References

  1. Hiesmayr M. Nutrition risk assessment in the ICU. Curr Opin Clin Nutr Metab Care 2012;15:174-80.  https://doi.org/10.1097/MCO.0b013e328350767e
  2. Zusman O, Theilla M, Cohen J, Kagan I, Bendavid I, Singer P. Resting energy expenditure, calorie and protein consumption in critically ill patients: a retrospective cohort study. Crit Care 2016;20:367. 
  3. Klein CJ, Stanek GS, Wiles CE 3rd. Overfeeding macronutrients to critically ill adults: metabolic complications. J Am Diet Assoc 1998;98:795-806.  https://doi.org/10.1016/S0002-8223(98)00179-5
  4. Tatucu-Babet OA, Ridley EJ, Tierney AC. Prevalence of underprescription or overprescription of energy needs in critically ill mechanically ventilated adults as determined by indirect calorimetry: a systematic literature review. JPEN J Parenter Enteral Nutr 2016;40:212-25.  https://doi.org/10.1177/0148607114567898
  5. Villet S, Chiolero RL, Bollmann MD, et al. Negative impact of hypocaloric feeding and energy balance on clinical outcome in ICU patients. Clin Nutr 2005;24:502-9.  https://doi.org/10.1016/j.clnu.2005.03.006
  6. Moonen HP, Beckers KJ, van Zanten AR. Energy expenditure and indirect calorimetry in critical illness and convalescence: current evidence and practical considerations. J Intensive Care 2021;9:8. 
  7. McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr 2016;40:159-211.  https://doi.org/10.1177/0148607115621863
  8. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr 2019;38:48-79.  https://doi.org/10.1016/j.clnu.2018.08.037
  9. Vasileiou G, Qian S, Iyengar R, et al. Use of predictive equations for energy prescription results in inaccurate estimation in trauma patients. Nutr Clin Pract 2020;35:927-32.  https://doi.org/10.1002/ncp.10372
  10. Ma DS, Lee GJ. Comparison of resting energy expenditure using indirect calorimetry and predictive equations in trauma patients: a pilot study. J Trauma Inj 2021;34:13-20.  https://doi.org/10.20408/jti.2021.0023
  11. Rogobete AF, Grintescu IM, Bratu T, et al. Assessment of metabolic and nutritional imbalance in mechanically ventilated multiple trauma patients: from molecular to clinical outcomes. Diagnostics (Basel) 2019;9:171. 
  12. Byerly SE, Yeh DD. The role of indirect calorimetry in care of the surgical patient. Curr Surg Rep 2022;10:186-91.  https://doi.org/10.1007/s40137-022-00326-9
  13. White JV, Guenter P, Jensen G, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). J Acad Nutr Diet 2012;112:730-8.  https://doi.org/10.1016/j.jand.2012.03.012
  14. Singer P, Berger MM, Van den Berghe G, et al. ESPEN guidelines on parenteral nutrition: intensive care. Clin Nutr 2009;28:387-400.  https://doi.org/10.1016/j.clnu.2009.04.024
  15. Harris JA, Benedict FG. A biometric study of human basal metabolism. Proc Natl Acad Sci U S A 1918;4:370-3.  https://doi.org/10.1073/pnas.4.12.370
  16. Ireton-Jones CS, Turner WW Jr, Liepa GU, Baxter CR. Equations for the estimation of energy expenditures in patients with burns with special reference to ventilatory status. J Burn Care Rehabil 1992;13:330-3.  https://doi.org/10.1097/00004630-199205000-00005
  17. Frankenfield D, Smith JS, Cooney RN. Validation of 2 approaches to predicting resting metabolic rate in critically ill patients. JPEN J Parenter Enteral Nutr 2004;28:259-64.  https://doi.org/10.1177/0148607104028004259
  18. Kwon J, Lee JH, Kim M, Choi D. Nutritional assessment formulae for nutritional requirement determination in severe trauma. Asia Pac J Clin Nutr 2022;31:611-8. 
  19. Lee SJ, Lee HJ, Jung YJ, Han M, Lee SG, Hong SK. Comparison of measured energy expenditure using indirect calorimetry vs predictive equations for liver transplant recipients. JPEN J Parenter Enteral Nutr 2021;45:761-7.  https://doi.org/10.1002/jpen.1932
  20. Kamel AY, Robayo L, Liang D, et al. Estimated vs measured energy expenditure in ventilated surgical-trauma critically ill patients. JPEN J Parenter Enteral Nutr 2022;46:1431-40.  https://doi.org/10.1002/jpen.2314
  21. Zusman O, Kagan I, Bendavid I, Theilla M, Cohen J, Singer P. Predictive equations versus measured energy expenditure by indirect calorimetry: a retrospective validation. Clin Nutr 2019;38:1206-10. https://doi.org/10.1016/j.clnu.2018.04.020