title: Fulfilling caloric demands according to indirect calorimetry may be beneficial for post cardiac arrest patients under therapeutic hypothermia.
abstract: BACKGROUND
  We sought to investigate the energy requirements for patients under therapeutic hypothermia, and the relationship of energy fulfillment to patient outcome.
  
  
  METHODS
  Adult patients admitted to our ICU after successful resuscitation from cardiac arrest for post resuscitation therapeutic hypothermia from April, 2012 to March, 2014 were enrolled. Body temperature was managed using the surface cooling device (Arctic Sun(®), IMI). Calorimeter module on the ventilator (Engström carestation(®), GE) was used for indirect calorimetry. Energy expenditure (EE) and respiratory quotient (RQ) were recorded continuously, as the average of the recent 2h. Measurements were started at the hypothermic phase and continued until the rewarming was completed. Cumulative energy deficit was calculated as the sum of difference between EE and daily energy provision for the 4 days during hypothermia therapy.
  
  
  RESULTS
  Seven patients were eligible for analysis. Median EE for the hypothermic phase (day 1) was 1557.0kcald(-1). EE was elevated according with the rise in body temperature, reaching 2375kcald(-1) at normothermic phase. There was significant association between cumulative energy deficit and the length of ICU stay, among patients with good neurologic recovery (cerebral performance category (CPC): 1-3).
  
  
  CONCLUSIONS
  The EE for patients under therapeutic hypothermia was higher than expected. Meeting the energy demand may improve patient outcome, as observed in the length of ICU stay for the present study. A larger, prospective study is awaited to validate the results of our study.
authors.affiliation: Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan. Electronic address: t_oshima@chiba-u.jp.
authors.forename: Taku
authors.initials: T
authors.lastname: Oshima
authors.affiliation: Medical Engineering Center, Chiba University Hospital, Chiba, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Furukawa
authors.affiliation: Medical Engineering Center, Chiba University Hospital, Chiba, Japan.
authors.forename: Michihiko
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Clinical Nutrition, Chiba University Hospital, Chiba, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Clinical Nutrition, Chiba University Hospital, Chiba, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Nihei
authors.affiliation: Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Oda
mesh_terms: D000328:Adult; D001831:Body Temperature / Q000502:physiology*; D002153:Calorimetry, Indirect; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Indirect calorimetry; Nutrition; Post cardiac arrest; Therapeutic hypothermia