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Energy expenditure in COVID-19 mechanically ventilated patients: A comparison of three methods of energy estimation.
Saseedharan, Sanjith; Chada, Radha Reddy; Kadam, Vaijayanti; Chiluka, Annapurna; Nagalla, Balakrishna.
  • Saseedharan S; Department of Intensive Care, S L Raheja Hospital-A Fortis Associate, Mumbai, Maharashtra, India.
  • Chada RR; Department of Clinical Nutrition and Dietetics, AIG Hospitals, Hyderabad, Telangana, India.
  • Kadam V; Department of Intensive Care, S L Raheja Hospital-A Fortis Associate, Mumbai, Maharashtra, India.
  • Chiluka A; Department of Intensive Care, S L Raheja Hospital-A Fortis Associate, Mumbai, Maharashtra, India.
  • Nagalla B; Department of Statistics, Apollo Hospitals Educational And Research Foundation, Hyderabad, Telangana, India.
JPEN J Parenter Enteral Nutr ; 46(8): 1875-1882, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1881433
ABSTRACT

BACKGROUND:

Indirect calorimetry (IC) is the gold standard for measuring resting energy expenditure. Energy expenditure (EE) estimated by ventilator-derived carbon dioxide consumption (EEVCO2 ) has also been proposed. In the absence of IC, predictive weight-based equations have been recommended to estimate daily energy requirements. This study aims to compare simple predictive weight-based equations with those estimated by EEVCO2 and IC in mechanically ventilated patients of COVID-19.

METHODS:

Retrospective study of a cohort of critically ill adult patients with COVID-19 requiring mechanical ventilation and artificial nutrition to compare energy estimations by three methods through the calculation of bias and precision agreement, reliability, and accuracy rates.

RESULTS:

In 58 mechanically ventilated patients, a total of 117 paired measurements were obtained. The mean estimated energy derived from weight-based calculations was 2576 ± 469 kcal/24 h, as compared with 1507 ± 499 kcal/24 h when EE was estimated by IC, resulting in a significant bias of 1069 kcal/day (95% CI [-2158 to 18.7 kcal]; P < 0.001). Similarly, estimated mean EEVCO2 was 1388 ± 467 kcal/24 h when compared with estimation of EE from IC. A significant bias of only 118 kcal/day (95% CI [-187 to 422 kcal]; P < 0.001), compared by the Bland-Altman plot, was noted.

CONCLUSION:

The energy estimated with EEVCO2 correlated better with IC values than energy derived from weight-based calculations. Our data suggest that the use of simple predictive equations may potentially lead to overfeeding in mechanically ventilated patients with COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiration, Artificial / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: JPEN J Parenter Enteral Nutr Year: 2022 Document Type: Article Affiliation country: Jpen.2393

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiration, Artificial / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: JPEN J Parenter Enteral Nutr Year: 2022 Document Type: Article Affiliation country: Jpen.2393