title: The use of indirect calorimetry in the intensive care unit.
abstract: OBJECTIVE
  This review evaluates whether improvements have occurred in the value of predictive equations for use in designing nutritional therapeutic regimens in the ICU. The report also seeks to determine whether emerging strategies for nutrition therapy in the ICU change the need for an accurate measurement of energy requirements by indirect calorimetry.
  
  
  RESULTS
  Predictive equations remain problematic for use in the critically ill patient. Inaccuracy of predictive equations introduces error in the design of a nutritional therapy regimen. The epidemic of obesity renders the calculations of requirements by predictive equations increasingly inaccurate at extremes of BMI. Certain patient populations appear to be hypometabolic, contradicting the traditional notion that critical illness increases energy expenditure. More recent data indicates that determination of which patients benefit from nutritional therapy may be based both on assessment of nutrition risk and delivery of sufficient nutrition therapy.
  
  
  CONCLUSIONS
  The role of indirect calorimetry in the ICU should be expected to increase in the near future, as predictive equations may be too inaccurate to identify the appropriate goals of nutrition therapy.
authors: Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA. Stephen.McClave@louisville.edu
authors: Stephen A
authors: SA
authors: McClave
authors: Robert G
authors: RG
authors: Martindale
authors: Laszlo
authors: L
authors: Kiraly
mesh_terms: D015992:Body Mass Index; D002153:Calorimetry, Indirect / Q000379:methods*; D016638:Critical Illness / Q000628:therapy; D002149:Energy Intake; D004734:Energy Metabolism; D006801:Humans; D007362:Intensive Care Units; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D018529:Nutritional Support; D009765:Obesity / Q000178:diet therapy