Do we need different predictive equations for the acute and late phases of critical illness? A prospective observational study with repeated indirect calorimetry measurements

Tah, Pei Chien and Poh, Bee Koon and Kee, Chee Cheong and Lee, Zheng-Yii and Hakumat-Rai, Vineya-Rai and Mat Nor, Mohd Basri and Kamarul Zaman, Mazuin and Abdul Majid, Hazreen and Hasan, Mohd Shahnaz (2021) Do we need different predictive equations for the acute and late phases of critical illness? A prospective observational study with repeated indirect calorimetry measurements. European Journal of Clinical Nutrition. pp. 1-8. ISSN 0954-3007 E-ISSN 1476-5640 (In Press)

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Abstract

BACKGROUND: Predictive equations (PEs) for estimating resting energy expenditure (REE) that have been developed from acute phase data may not be applicable in the late phase and vice versa. This study aimed to assess whether separate PEs are needed for acute and late phases of critical illness and to develop and validate PE(s) based on the results of this assessment. METHODS: Using indirect calorimetry, REE was measured at acute (≤5 days; n = 294) and late (≥6 days; n = 180) phases of intensive care unit admission. PEs were developed by multiple linear regression. A multi-fold cross-validation approach was used to validate the PEs. The best PEs were selected based on the highest coefficient of determination (R2), the lowest root mean square error (RMSE) and the lowest standard error of estimate (SEE). Two PEs developed from paired 168-patient data were compared with measured REE using mean absolute percentage difference. RESULTS: Mean absolute percentage difference between predicted and measured REE was <20%, which is not clinically significant. Thus, a single PE was developed and validated from data of the larger sample size measured in the acute phase. The best PE for REE (kcal/day) was 891.6(Height) + 9.0(Weight) + 39.7(Minute Ventilation)−5.6(Age) – 354, with R2 = 0.442, RMSE = 348.3, SEE = 325.6 and mean absolute percentage difference with measured REE was: 15.1 ± 14.2% [acute], 15.0 ± 13.1% [late]. CONCLUSIONS: Separate PEs for acute and late phases may not be necessary. Thus, we have developed and validated a PE from acute phase data and demonstrated that it can provide optimal estimates of REE for patients in both acute and late phases.

Item Type:	Article (Journal)
Additional Information:	5608/92765
Uncontrolled Keywords:	predictive equations, critical illness, indirect calorimetry
Subjects:	R Medicine > RC Internal medicine > RC620 Specialties of Internal Medicine-Nutritional Diseases R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine Kulliyyah of Medicine > Department of Surgery
Depositing User:	Dr. Mohd Basri Mat Nor
Date Deposited:	28 Oct 2021 11:01
Last Modified:	28 Feb 2022 08:22
URI:	http://irep.iium.edu.my/id/eprint/92765

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