title: Evaluation of a non-invasive multisensor accelerometer for calculating energy expenditure in ventilated intensive care patients compared to indirect calorimetry and predictive equations.
abstract: Continuous measurement of resting energy expenditure (REE) in critically ill patients remains challenging but is required to prevent malnutrition. SenseWear Pro 3 Armband (SWA) is a research grade accelerometer for assessment of REE with the advantage of easy handling. In a prospective study we compared SWA with indirect calorimetry (IC) and predictive equations in critically ill, ventilated patients. REE was measured by SWA, IC and calculated by predictive formulas. Potential confounding factors that influence REE were also recorded. Results of SenseWear Armband and indirect calorimetry were compared using the Bland-Altman method. 34 ICU patients were investigated. SWA underestimated resting energy expenditure compared to IC with a mean bias of ΔREE = -253.6 ± 333.2 kcal, equivalent to -11.7 % (p = 0.025). This underestimation was seen in both, medical (-14.9 %) and surgical (-12.9 %) patients and the bias was greater in patients with fever (-19.0 %), tachycardia (-18.7 %) or tachypnea (-26.2 %). Differences were also noted when SWA was compared to predictive formulas. At present, SWA cannot be regarded as an alternative to indirect calorimetry. Individual measurements are often inaccurate and should be used with caution until improved algorithms, based on the results of this study, have been implemented.
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Krüger
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Kraft
authors.affiliation: Department of Anaesthesiology and Intensive Care, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Gründling
authors.affiliation: Department of Medicine B, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Sigrun
authors.initials: S
authors.lastname: Friesecke
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Gärtner
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.
authors.forename: Lena J
authors.initials: LJ
authors.lastname: Vogt
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Schüler
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Steveling
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany. lerch@uni-greifswald.de.
authors.forename: Markus M
authors.initials: MM
authors.lastname: Lerch
authors.affiliation: Department of Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.
authors.forename: Ali A
authors.identifier: http://orcid.org/0000-0002-0569-7316
authors.initials: AA
authors.lastname: Aghdassi
mesh_terms: D061725:Accelerometry / Q000379:methods*; D000368:Aged; D000465:Algorithms; D000886:Anthropometry; D015992:Body Mass Index; D002153:Calorimetry, Indirect / Q000379:methods*; D003422:Critical Care; D016638:Critical Illness; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012146:Rest; D012122:Ventilators, Mechanical
keywords: Critically ill; Energy expenditure; Indirect calorimetry; Predictive equations; SenseWear Pro Armband