Two-hour indirect calorimetry measurement as a predictor of 24-hour energy expenditure in critically ill surgical patients: A longitudinal study

Yael Lichter*, Oded Sold, Yoel Angel, Eran Nizri, Fabian Gerstenhaber, Amir Gal Oz, Dekel Stavi, Asaph Nini, Pierre Singer, Noam Goder

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Measuring energy expenditure (EE) by indirect calorimetry (IC) has become the gold standard tool for critically ill patients to define energy targets and tailor nutrition. Debate remains as to the optimal duration of measurements or the optimal time of day in which to perform IC. Methods: In this retrospective longitudinal study, we analyzed results of daily continuous IC in 270 mechanically ventilated, critically ill patients admitted to the surgical intensive care unit in a tertiary medical center and compared measurements performed at different hours of the day. Results: A total of 51,448 IC hours was recorded, with an average 24-h EE of 1523 ± 443 kcal/day. Night shift (00:00–8:00) was found to have significantly lower EE measurements (mean, 1499 ± 439 kcal/day) than afternoon (16:00–00:00; mean, 1526 ± 435 kcal/day) and morning (8:00–16:00; mean, 1539 ± 462 kcal/day) measurements (P < 0.001 for all). The bi-hourly time frame that most closely resembled the daily mean was 18:00–19:59, with a mean of 1521 ± 433 kcal/day. Daily EE measurements of the continuous IC at days 3–7 of admission showed a trend toward a daily increase in 24-h EE, but the difference was not statistically significant (P = 0.081). Conclusions: Periodic measurements of EE can differ slightly when performed at various hours of the day, but the error range is small and may not necessarily have a clinical impact. When continuous IC is not available, a 2-h EE measurement between 18:00 and 19:59 can serve as a reasonable alternative.

Original languageEnglish
Pages (from-to)896-903
Number of pages8
JournalJournal of Parenteral and Enteral Nutrition
Volume47
Issue number7
DOIs
StatePublished - Sep 2023

Keywords

  • critically ill patients
  • energy expenditure
  • indirect calorimetry
  • nutrition

Fingerprint

Dive into the research topics of 'Two-hour indirect calorimetry measurement as a predictor of 24-hour energy expenditure in critically ill surgical patients: A longitudinal study'. Together they form a unique fingerprint.

Cite this