title: [Determination of resting energy expenditure in critically ill children experiencing mechanical ventilation].
abstract: OBJECTIVE
  Energy metabolism of critically ill children has its own characteristics, especially for those undergoing mechanical ventilation. We tried to assess the energy expenditure status and evaluate the use of predictive equations in such children. Moreover, the characteristics of the energy metabolism among various situation were explored.
  
  
  METHODS
  Fifty critically ill children undergoing mechanical ventilation were selected in this study. Data produced during the 24 hours of mechanical ventilation were collected for computation of severity of illness. Resting energy expenditure (REE) was determined at 24 hours after mechanical ventilation (MREE). Predictive resting energy expenditure (PREE) was calculated for each subject using age-appropriate equations (Schofield-HTWT, White). The study was approved by the hospital medical ethics committee and obtained parental written informed consent.
  
  
  RESULTS
  The pediatric risk of mortality score 3 (PRISM3) and pediatric critical illness score (PCIS) were (7 ± 3) and (82 ± 4), respectively. MREE, Schofield-HTWT equation PREE and White equation PREE were (404.80 ± 178.28), (462.82 ± 160.38) and (427.97 ± 152.30) kcal/d, respectively; 70% were hypometabolic and 10% were hypermetabolic. MREE and PREE which were calculated using Schofield-HTWT equation and White equation, both were higher than MREE (P = 0.029). Correlation analysis was performed between PRISM3 and PCIS with MREE. There were no statistically significant correlation (P > 0.05).
  
  
  CONCLUSIONS
  The hypometabolic response is apparent in critically ill children with mechanical ventilation; Schofield-HTWT equation and White equation could not predict energy requirements within acceptable clinical accuracy. In critically ill children undergoing mechanical ventilation, the energy expenditure is not correlated with the severity of illness.
authors.affiliation: Pediatric Intensive Care Unit, Shanghai Children's Medical Center, Shanghai 200127, China.
authors.forename: Hong-ba
authors.initials: HB
authors.lastname: Dong
authors.forename: Yan-wen
authors.initials: YW
authors.lastname: Yang
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Li
authors.initials: L
authors.lastname: Hong
mesh_terms: D001481:Basal Metabolism / Q000502:physiology; D001835:Body Weight; D002153:Calorimetry, Indirect; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D009751:Nutritional Requirements; D010101:Oxygen Consumption; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012121:Respiration, Artificial; D012146:Rest / Q000502:physiology*; D012720:Severity of Illness Index