The use of indirect calorimetry in the intensive care unit

Stephen A. McClave, Robert G. Martindale, Laszlo Kiraly

Research output: Contribution to journalReview article

45 Scopus citations

Abstract

Purpose of Review: This review evaluates whether improvements have occurred in the value of predictive equations for use in designing nutritional therapeutic regimens in the ICU. The report also seeks to determine whether emerging strategies for nutrition therapy in the ICU change the need for an accurate measurement of energy requirements by indirect calorimetry. Recent Findings: Predictive equations remain problematic for use in the critically ill patient. Inaccuracy of predictive equations introduces error in the design of a nutritional therapy regimen. The epidemic of obesity renders the calculations of requirements by predictive equations increasingly inaccurate at extremes of BMI. Certain patient populations appear to be hypometabolic, contradicting the traditional notion that critical illness increases energy expenditure. More recent data indicates that determination of which patients benefit from nutritional therapy may be based both on assessment of nutrition risk and delivery of sufficient nutrition therapy. Summary: The role of indirect calorimetry in the ICU should be expected to increase in the near future, as predictive equations may be too inaccurate to identify the appropriate goals of nutrition therapy.

Original languageEnglish (US)
Pages (from-to)202-208
Number of pages7
JournalCurrent Opinion in Clinical Nutrition and Metabolic Care
Volume16
Issue number2
DOIs
StatePublished - Mar 1 2013

Keywords

  • body mass index
  • energy expenditure
  • hypocaloric feeding
  • indirect calorimetry
  • obesity
  • permissive underfeeding

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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