title: Performance of Predictive Equations Specifically Developed to Estimate Resting Energy Expenditure in Ventilated Critically Ill Children.
abstract: To determine, based on indirect calorimetry measurements, the biases of predictive equations specifically developed recently for estimating resting energy expenditure (REE) in ventilated critically ill children, or developed for healthy populations but used in critically ill children.
  
  
  
  A secondary analysis study was performed using our data on REE measured in a previous prospective study on protein and energy needs in pediatric intensive care unit. We included 75 ventilated critically ill children (median age, 21 months) in whom 407 indirect calorimetry measurements were performed. Fifteen predictive equations were used to estimate REE: the equations of White, Meyer, Mehta, Schofield, Henry, the World Health Organization, Fleisch, and Harris-Benedict and the tables of Talbot. Their differential and proportional biases (with 95% CIs) were computed and the bias plotted in graphs. The Bland-Altman method was also used.
  
  
  
  Most equations underestimated and overestimated REE between 200 and 1000 kcal/day. The equations of Mehta, Schofield, and Henry and the tables of Talbot had a bias ≤10%, but the 95% CI was large and contained values by far beyond ±10% for low REE values. Other specific equations for critically ill children had even wider biases.
  
  
  
  In ventilated critically ill children, none of the predictive equations tested met the performance criteria for the entire range of REE between 200 and 1000 kcal/day. Even the equations with the smallest bias may entail a risk of underfeeding or overfeeding, especially in the youngest children. Indirect calorimetry measurement must be preferred.
authors.affiliation: Department of Nutrition and Dietetics, School of Health Professions, University of Applied Sciences Western Switzerland, Geneva 1227, Switzerland; Pediatric Intensive Care Unit, Medico-Surgical Department of Pediatrics, University Hospital of Lausanne, Lausanne 1011, Switzerland.
authors.forename: Corinne
authors.initials: C
authors.lastname: Jotterand Chaparro
authors.affiliation: Institute of Social and Preventive Medicine, Lausanne 1010, Switzerland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Taffé
authors.affiliation: Department of Nutrition and Dietetics, School of Health Professions, University of Applied Sciences Western Switzerland, Geneva 1227, Switzerland.
authors.forename: Clémence
authors.initials: C
authors.lastname: Moullet
authors.affiliation: Department of Nutrition and Dietetics, School of Health Professions, University of Applied Sciences Western Switzerland, Geneva 1227, Switzerland.
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Laure Depeyre
authors.affiliation: Pediatric Intensive Care Unit, Medico-Surgical Department of Pediatrics, University Hospital of Lausanne, Lausanne 1011, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Longchamp
authors.affiliation: Pediatric Intensive Care Unit, Medico-Surgical Department of Pediatrics, University Hospital of Lausanne, Lausanne 1011, Switzerland.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Perez
authors.affiliation: Pediatric Intensive Care Unit, Medico-Surgical Department of Pediatrics, University Hospital of Lausanne, Lausanne 1011, Switzerland. Electronic address: jacques.cotting@chuv.ch.
authors.forename: Jacques
authors.initials: J
authors.lastname: Cotting
mesh_terms: D002153:Calorimetry, Indirect; D002675:Child, Preschool; D016638:Critical Illness; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D055641:Mathematical Concepts; D012121:Respiration, Artificial; D012146:Rest
keywords: bias plot; critical care; energy expenditure; estimation; indirect calorimetry; pediatrics; precision plot