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Nutrición Hospitalaria

versão On-line ISSN 1699-5198versão impressa ISSN 0212-1611

Resumo

RAURICH, Joan María et al. A simplified equation for total energy expenditure in mechanically ventilated critically ill patients. Nutr. Hosp. [online]. 2015, vol.32, n.3, pp.1273-1280. ISSN 1699-5198.  https://dx.doi.org/10.3305/nh.2015.32.3.9359.

Introduction: gtight calorie controlh concept arose to avoid over- and under-feeding of patients. Objective: to describe and validate a simplified predictive equation of total energy expenditure (TEE) in mechanically ventilated critically ill patients. Methods: this was a secondary analysis of measurements of TEE by indirect calorimetry in critically ill patients. Patients were allocated in a 2:1 form by a computer package to develop the new predictive equation TEE (prediction cohort) and the validation cohort. Indirect calorimetry was performed with three different calorimeters: the Douglas-bag, a metabolic computer and the Calorimet®. We developed a new TEE predictive equation using measured TEE (in kcal/kg/d) as dependent variable and as independent variables different factors known to influence energy expenditure: age, gender, body mass index (BMI) and type of injury. Results: prediction cohort: 179 patients. Validation cohort: 91 patients. The equation was: TEEPE (kcal/Kg/d) = 33 - (3 x A) - (3 x BMI) - (1 x G). Where: A (age in years): ≤ 50 = 0; > 50 = 1. BMI (Kg/m2): 18.5 . 24.9 = 0; 25 . 29.9 = 1; 30 . 34.9 = 2; 35 . 39.9 = 3. G (gender): male = 0; female = 1. The bias (95% CI) was -0.1 (-1.0 . 0.7) kcal/kg/d and the limits of agreement (± 2SD) were -8.0 to 7.8 kcal/kg/d. Predicted TEE was accurate (within 85% to 115%) in 73.6% of patients. Conclusion: the new predictive equation was acceptable to predict TEE in clinical practice for most mechanically ventilated critically ill patients.

Palavras-chave : Total energy expenditure; Resting energy expenditure; Critically ill patients; Mechanical ventilation.

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