title: Indirect calorimetry in patients with active respiratory infection--prevention of cross-infection.
abstract: BACKGROUND
  Measurement of resting energy expenditure in patients with active respiratory infection is hampered by the risk of contamination of indirect calorimeters and connecting tubes that cannot be sterilized. This validation study tested whether the use of disposable standard-bore air tubes and an antibacterial filter, by reducing air flow, introduces an error due to recirculation of expired air in the canopy.
  
  
  METHODS
  Eleven healthy volunteers underwent indirect calorimetry twice in random order, using a Deltatrac calorimeter either with standard wide-bore tubing or with a disposable standard-bore air tube and filter. Methods were compared by Bland-Altman plots and by calculating trends over time.
  
  
  RESULTS
  The new tube and filter reduced air flow by 40%. Measured resting energy expenditure did not differ significantly between methods, with limits of agreement -135 to +188 kcal/d. Carbon dioxide flow (VCO(2)) and respiratory quotient (RQ), but not oxygen flow decreased slowly over time with both methods.
  
  
  CONCLUSIONS
  The use of an air filter and standard-bore tubes do not introduce a systematic error into indirect calorimetry. Although trends in VCO(2) and RQ are consistent with minor recirculation of exhaled air, this modified Deltatrac system can be safely and reliably used to measure resting energy expenditures in patients with active tuberculosis and other airborne infection.
authors.affiliation: Department of Infectious Diseases, St. George's Hospital Medical School, London, UK.
authors.forename: Achim
authors.initials: A
authors.lastname: Schwenk
authors.forename: Pekka T
authors.initials: PT
authors.lastname: Meriläinen
authors.forename: Derek C
authors.initials: DC
authors.lastname: Macallan
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002153:Calorimetry, Indirect; D002245:Carbon Dioxide / Q000502:physiology; D003428:Cross Infection / Q000517:prevention & control*; D004209:Disposable Equipment; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D012016:Reference Values; D012119:Respiration; D012141:Respiratory Tract Infections / Q000503:physiopathology*
chemical_list: D002245:Carbon Dioxide