Day-to-day variability of energy expenditure in critically ill surgical patients.
To determine whether the total energy expenditure (TEE) determined on a single day reliably estimates TEE on subsequent days of a patient's ICU stay, day-to-day variability of TEE and its relation to clinical condition were assessed. TEE was measured by indirect calorimetry in 60 mechanically ventilated critically ill surgical patients during a 2 to 7-day period. Clinical condition was scored by daily determination of the simplified acute physiology score (SAPS). Day-to-day variation of TEE was significantly (p less than .0001) influenced by body temperature, but not by SAPS or day of measurement. In the individual patient, day-to-day variability of TEE may be large. When TEE on day 1 is used to estimate TEE on subsequent days, errors of up to 31% of actual TEE occurred. Addition of a temperature correction reduced the maximum error to 25%. If a balance between caloric supply and demand is intended, it is advised to adapt the caloric supply to the result of daily TEE measurement by indirect calorimetry.
Vermeij
C G
CG
Department of General Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands.
Feenstra
B W
BW
van Lanschot
J J
JJ
Bruining
H A
HA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001831:Body Temperature; D002153:Calorimetry, Indirect; D003422:Critical Care / Q000379:methods*; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011184:Postoperative Period