A Reduced Abbreviated Indirect Calorimetry Protocol Is Clinically Acceptable for Use in Spontaneously Breathing Patients With Traumatic Brain Injury
- 30 April 2009
- journal article
- research article
- Published by Wiley in Nutrition in Clinical Practice
- Vol. 24 (4), 513-519
- https://doi.org/10.1177/0884533609335308
Abstract
A steady state should be established when using indirect calorimetry to assess resting energy expenditure, reduce error, and improve the validity of the measurement. Steady-state criteria are often rigorous and difficult to achieve in hospitalized patients, particularly in patients recovering from traumatic brain injury. This study aimed to assess whether reducing the timeframe for steady-state conditions to 2, 3, or 4 minutes when using indirect calorimetry was significantly different from the widely accepted 5-minute steady-state protocol in patients recovering from traumatic brain injury. Indirect calorimetry using an open-circuit calorimeter was used to measure resting energy expenditure in 20 spontaneously breathing patients with traumatic brain injury. Each patient underwent repeated measurements once per day at various stages of his or her recovery. Bland-Altman methods comparison was used for statistical analysis. In total, 124 measurements were recorded, of which 59% met 5-minute, 70% met 4-minute, 76% met 3-minute, and 84% met 2-minute steady-state conditions. Mean within-patient coefficient of variation was 13% (range, 0%-35%). Agreement at the ±10% level using Bland-Altman plots was 100% for a 4-minute steady-state protocol, 96% for a 3-minute protocol, and 90% using a 2-minute protocol. A 4-minute or 3-minute abbreviated steady-state indirect calorimetry protocol is clinically acceptable to measure resting energy expenditure in spontaneously breathing patients with a traumatic brain injury.Keywords
This publication has 29 references indexed in Scilit:
- Nutritional support for head-injured patientsEmergencias, 2006
- Accuracy of 30‐Minute Indirect Calorimetry Studies in Predicting 24‐Hour Energy Expenditure in Mechanically Ventilated, Critically Ill PatientsJournal of Parenteral and Enteral Nutrition, 1997
- Validation of a 5-minute steady state indirect calorimetry protocol for resting energy expenditure in critically ill patients.Journal of the American College of Nutrition, 1996
- Invited Review: Use of Indirect Calorimetry in Clinical NutritionNutrition in Clinical Practice, 1992
- Estimating Energy Expenditure in Traumatic Brain InjuryNeurosurgery, 1992
- Evolution of energy expenditure and nitrogen excretion in severe head-injured patientsCritical Care Medicine, 1991
- Intra-individual variability and measurement noise in estimates of energy expenditure by whole body indirect calorimetryBritish Journal of Nutrition, 1987
- Caloric requirements in patients with severe head injuriesSurgical Neurology, 1986
- Metabolic and Nutritional Sequelae in the Non-Steroid Treated Head Injury PatientNeurosurgery, 1985
- Underfeeding and overfeeding and their clinical consequencesProceedings of the Nutrition Society, 1976