title: Validation of the V(max) metabolic cart in a simulated pediatric model.
abstract: BACKGROUND
  The ability to accurately measure resting energy expenditure (REE) using indirect calorimetry, often referred to as the "gold standard" in nutrition needs assessment, is important given the well-established positive correlation between patient outcome and proportion of the nutrition goal met. While many studies have been done to compare various metabolic carts with one another, the literature lacks a large simulator-based validation of any metabolic cart system.
  
  
  METHODS
  In the present study, 8 specifically trained staff members independently conducted 10 simulation trials each using the V(max) Encore metabolic analyzer in conjunction with a metabolic calibration system, which simulates patient metabolic activity, to validate the accuracy of the V(max) Encore across a wide range of simulated metabolic conditions. Testing conditions consisted of incremental adjustments in calibrated gas infusion with a consistently set tidal volume and respiratory rate.
  
  
  RESULTS
  There was a strong, statistically significant correlation between the predicted and actual VO2 and VCO2 data (VO2, R (2) = 0.998; VCO2, R (2) = 0.997). In addition, we observed no significant difference between individuals performing these trials (VO2, P = 1.000, F = 0.021, df = 79; VCO2, P = 1.000, F = 0.030, df = 79).
  
  
  CONCLUSIONS
  This study is the first to report on such a wide spectrum of metabolic activity (50-2000 kcal REE) using a calibrated bench model and validates the accuracy, reproducibility, and use of the V(max) Encore metabolic cart.
authors.affiliation: C. S. Mott Children's Hospital & Von Voigtlander Women's Hospital, Ann Arbor, Michigan kwines@umich.edu.
authors.forename: Kristen N
authors.initials: KN
authors.lastname: Wines
authors.affiliation: C. S. Mott Children's Hospital & Von Voigtlander Women's Hospital, Ann Arbor, Michigan.
authors.forename: Alexandra K
authors.initials: AK
authors.lastname: Rzepecki
authors.affiliation: C. S. Mott Children's Hospital & Von Voigtlander Women's Hospital, Ann Arbor, Michigan.
authors.forename: Audrey L
authors.initials: AL
authors.lastname: Andrews
authors.affiliation: C. S. Mott Children's Hospital & Von Voigtlander Women's Hospital, Ann Arbor, Michigan.
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Dechert
mesh_terms: D001481:Basal Metabolism; D002138:Calibration; D002153:Calorimetry, Indirect / Q000379:methods* / Q000592:standards; D002245:Carbon Dioxide / Q000378:metabolism; D002648:Child; D002149:Energy Intake; D004734:Energy Metabolism; D006801:Humans; D008954:Models, Biological; D010101:Oxygen Consumption; D011659:Pulmonary Gas Exchange; D015203:Reproducibility of Results; D012146:Rest
chemical_list: D002245:Carbon Dioxide
keywords: Vmax Encore; bench trial; metabolic cart; pediatric; simulation; validation