Elisabeth De Waele1,2,3, Joop Jonckheer2, Paul E Wischmeyer4. 1. Department of Clinical Nutrition. 2. Department of Intensive Care Medicine. 3. Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium. 4. Department of Anesthesiology and Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
Abstract
PURPOSE OF REVIEW: Review recent literature on the role of indirect calorimetry in critical care nutrition management. RECENT FINDINGS: Critical illness demands objective, targeted nutritional therapy to prevent adverse effects of underfeeding/over feeding. Thus, all recent societal guidelines recommend indirect calorimetry use to determine energy needs. Very recently, indirect calorimetry technology has finally evolved to allow for accurate, simple, and routine utilization in a wider range of ICU patients. Recent data continues to confirm poor correlation between measured and equation-predicted energy expenditure emphasizing need for indirect calorimetry to be standard of care. This may be particularly true in COVID-19, where significant progressive hypermetabolism and variability in energy expenditure has been shown. Metabolic physiology can change frequently during ICU stay in response to changes in clinical condition or care. Thus, repeated longitudinal indirect calorimetry measures are needed throughout ICU stay to optimize care, with initial data showing improved clinical outcomes when indirect calorimetry targets are utilized. SUMMARY: Personalized ICU care demands objective data to guide therapy. This includes use of indirect calorimetry to determine energy expenditure and guide ICU nutrition therapy. Long-awaited new innovations in indirect calorimetry technology should finally lead to indirect calorimetry to becoming a fundamental component of modern ICU standard of care and clinical research moving forward.
PURPOSE OF REVIEW: Review recent literature on the role of indirect calorimetry in critical care nutrition management. RECENT FINDINGS: Critical illness demands objective, targeted nutritional therapy to prevent adverse effects of underfeeding/over feeding. Thus, all recent societal guidelines recommend indirect calorimetry use to determine energy needs. Very recently, indirect calorimetry technology has finally evolved to allow for accurate, simple, and routine utilization in a wider range of ICU patients. Recent data continues to confirm poor correlation between measured and equation-predicted energy expenditure emphasizing need for indirect calorimetry to be standard of care. This may be particularly true in COVID-19, where significant progressive hypermetabolism and variability in energy expenditure has been shown. Metabolic physiology can change frequently during ICU stay in response to changes in clinical condition or care. Thus, repeated longitudinal indirect calorimetry measures are needed throughout ICU stay to optimize care, with initial data showing improved clinical outcomes when indirect calorimetry targets are utilized. SUMMARY: Personalized ICU care demands objective data to guide therapy. This includes use of indirect calorimetry to determine energy expenditure and guide ICU nutrition therapy. Long-awaited new innovations in indirect calorimetry technology should finally lead to indirect calorimetry to becoming a fundamental component of modern ICU standard of care and clinical research moving forward.
Authors: Elisabeth De Waele; Joop Jonckheer; Joeri J Pen; Joy Demol; Kurt Staessens; Luc Puis; Mark La Meir; Patrick M Honoré; Manu L N G Malbrain; Herbert D Spapen Journal: Acta Anaesthesiol Scand Date: 2018-11-06 Impact factor: 2.105
Authors: Elisabeth De Waele; Herbert Spapen; Patrick M Honoré; Sabrina Mattens; Viola Van Gorp; Marc Diltoer; Luc Huyghens Journal: J Crit Care Date: 2013-04-03 Impact factor: 3.425
Authors: Haifa Mtaweh; Maria Jose Soto Aguero; Marla Campbell; Johane P Allard; Paul Pencharz; Eleanor Pullenayegum; Christopher S Parshuram Journal: Clin Nutr ESPEN Date: 2019-07-11