title: Energy expenditure in acute posttraumatic amputation: comparison of four methods for assessment.
abstract: BACKGROUND
  Adequate energy intake is a component of successful recovery after injury, yet little is known about the energy requirements in the acute period following traumatic amputation. The purpose of this study was to compare the clinical applicability of resting energy expenditure (REE) measured by a handheld calorimeter and estimated by 3 different predictive equations to that measured by the gold standard, indirect calorimetry using a metabolic cart, during the acute postamputation period of inpatient hospitalization.
  
  
  METHODS
  Indirect calorimetry measured using both a metabolic cart and handheld calorimeter and predicted by 3 equations were used to assess energy needs of eligible subjects admitted to Brooke Army Medical Center with traumatic amputation(s). REE measured by the handheld calorimeter and estimated using 3 predictive equations (Mifflin St. Jeor, Ireton-Jones 1992, and the American College of Chest Physicians [ACCP]) were compared to the gold standard metabolic cart. Each measure was assessed for significant differences and level of clinical acceptability defined as ± 10% REE by metabolic cart.
  
  
  RESULTS
  Thirteen male service members with traumatic amputation(s) were included. The majority of subject's measurements using the handheld calorimeter (n = 9, 69%) and 3 predictive equations (Mifflin St. Jeor [n = 7, 54%], Ireton-Jones 1992 [n = 8, 62%], ACCP [n = 7, 54%]) fell outside of the ± 10% range of clinical acceptability.
  
  
  CONCLUSIONS
  Use of the metabolic cart for measuring energy needs remains optimal in this population.
authors.affiliation: Marybeth Salgueiro, DCN, Brooke Army Medical Center, 3551 Roger Brooke Drive, MCHE-DF, San Antonio, TX 78248, USA. Email: marybeth.salgueiro.mil@mail.mil.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Robins
authors.forename: Susan M
authors.initials: SM
authors.lastname: Stankorb
authors.forename: Marybeth
authors.initials: M
authors.lastname: Salgueiro
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D001481:Basal Metabolism; D015992:Body Mass Index; D002153:Calorimetry, Indirect / Q000379:methods*; D002149:Energy Intake; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008297:Male; D055641:Mathematical Concepts; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D055815:Young Adult
keywords: amputation; calorimeter; energy metabolism; indirect calorimetry; predictive equations; resting energy expenditure