Document Detail


Resting energy expenditure in non-ventilated, non-sedated patients recovering from serious traumatic brain injury: comparison of prediction equations with indirect calorimetry values.
MedLine Citation:
PMID:  19423202     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Little is known about energy requirements in brain injured (TBI) patients, despite evidence suggesting adequate nutritional support can improve clinical outcomes. The study aim was to compare predicted energy requirements with measured resting energy expenditure (REE) values, in patients recovering from TBI. METHODS: Indirect calorimetry (IC) was used to measure REE in 45 patients with TBI. Predicted energy requirements were determined using FAO/WHO/UNU and Harris-Benedict (HB) equations. Bland-Altman and regression analysis were used for analysis. RESULTS: One-hundred and sixty-seven successful measurements were recorded in patients with TBI. At an individual level, both equations predicted REE poorly. The mean of the differences of standardised areas of measured REE and FAO/WHO/UNU was near zero (-9 kcal) but the variation in both directions was substantial (range -591 to +573 kcal). Similarly, the differences of areas of measured REE and HB demonstrated a mean of 1.9 kcal and range -568 to +571 kcal. Glasgow coma score, patient status, weight and body temperature were significant predictors of measured REE (p<0.001; R(2)=0.47). CONCLUSIONS: Clinical equations are poor predictors of measured REE in patients with TBI. The variability in REE is substantial. Clinicians should be aware of the limitations of prediction equations when estimating energy requirements in TBI patients.
Authors:
Claire T McEvoy; Gordon W Cran; Stephen R Cooke; Ian S Young
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-05-07
Journal Detail:
Title:  Clinical nutrition (Edinburgh, Scotland)     Volume:  28     ISSN:  1532-1983     ISO Abbreviation:  Clin Nutr     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-13     Completed Date:  2010-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309603     Medline TA:  Clin Nutr     Country:  England    
Other Details:
Languages:  eng     Pagination:  526-32     Citation Subset:  IM    
Affiliation:
Centre for Public Health, Queens University Belfast, BT12 6BJ, Northern Ireland, UK. c.mcevoy@qub.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Algorithms*
Body Temperature
Body Weight
Brain Injuries / rehabilitation*
Calorimetry, Indirect*
Energy Metabolism / physiology*
Female
Glasgow Coma Scale
Health Status
Humans
Male
Middle Aged
Nutritional Requirements*
Oxygen Consumption
Practice Guidelines as Topic
Regression Analysis
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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