This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Weissman, C. Articles by Hyman, A. I. Search for Related Content PubMed PubMed Citation Articles by Weissman, C. Articles by Hyman, A. I.

Variation in the Resting Metabolic Rate of Mechanically Ventilated Critically Ill Patients

Departments of Anesthesiology and Medicine, College of Physicians and Surgeons, Columbia University, New York, New York.

Abstract

There has been increasing interest in the nutritional support of the critically ill patient. The day-to-day variation in resting energy expenditure (REE) was studied over a 35-day period in 17 postoperative mechanically ventilated critically ill patients to gain insight as to how often caloric intake should be reassessed, whether changes observed over 3–5 days are of sufficient magnitude to make frequent adjustments in caloric intake, and what factors are associated with large alterations in metabolic rate. REE was measured daily for 3–5 days, and the percent variation in REE [(highest REE - lowest daily REE)/(lowest daily REE) x 100] calculated. The variation ranged from 4 to 56%, and on further analysis two distinct groups were identified, one with a mean variation of 12 ± 4% (sD) (range 4–18%) and the other with a mean variation of 46 ± 8% (range 37–56%). The former group was clinically stable, whereas the latter was not. Clinically stable patients need less frequent measurements than those who are more ill, but when designing a nutritional regimen for them, at least 20–25% should be added to the REE, 15% to account for day-to-day variation and 5–10% for activity.

Key Words: METABOLISM, METABOLIC RATE—nutritional requirements • OXYGEN—consumption

This article has been cited by other articles:

				B. A. Anderegg, C. Worrall, E. Barbour, K. N. Simpson, and M. DeLegge Comparison of Resting Energy Expenditure Prediction Methods With Measured Resting Energy Expenditure in Obese, Hospitalized Adults JPEN J Parenter Enteral Nutr, March 1, 2009; 33(2): 168 - 175. [Abstract] [Full Text] [PDF]

				J. A. Hoher, P. J. Z. Teixeira, F. Hertz, and J. da S. Moreira A Comparison Between Ventilation Modes: How Does Activity Level Affect Energy Expenditure Estimates? JPEN J Parenter Enteral Nutr, March 1, 2008; 32(2): 176 - 183. [Abstract] [Full Text] [PDF]

				J. Krenitsky Adjusted Body Weight, Pro: Evidence to Support the Use of Adjusted Body Weight in Calculating Calorie Requirements Nutr Clin Pract, August 1, 2005; 20(4): 468 - 473. [Abstract] [Full Text] [PDF]

				R. D. Branson and J. A. Johannigman The Measurement of Energy Expenditure Nutr Clin Pract, December 1, 2004; 19(6): 622 - 636. [Abstract] [Full Text] [PDF]

				M. S. White, R. W. Shepherd, and J. A. McEniery Energy Expenditure Measurements in Ventilated Critically III Children: Within- and Between-Day Variability JPEN J Parenter Enteral Nutr, September 1, 1999; 23(5): 300 - 304. [Abstract] [PDF]

				N. A. Smyrnios, F. J. Curley, and K. G. Shaker Accuracy of 30-Minute Indirect Calorimetry Studies in Predicting 24-Hour Energy Expenditure in Mechanically Ventilated, Critically Ill Patients JPEN J Parenter Enteral Nutr, May 1, 1997; 21(3): 168 - 174. [Abstract] [PDF]