Prediction of energy expenditure in patients with severe traumatic brain injury: A validation study by use of continuous indirect calorimetry and doubly labelled water
(English)Manuscript (preprint) (Other academic)
Objective: The aim was to evaluate the accuracy of methods to predict energy expenditure (EE) in patients with severe traumatic brain injury (TBI).
Method: To this prospective descriptive study, a small cohort of patients (n6) with isolated, severe TBI and an expected hospital stay of ≥2-3 months were included. The EE was measured at two intervals: by continuous indirect calorimetry during mechanical ventilation and by doubly labelled water from 3rd to 5th week post injury. Different equations for prediction of EE and a portable monitor, the SenseWear Armband were compared to the measured EE.
Result: The majority of methods for predicting EE agreed poorly with the measured EE during indirect calorimetry period. A good agreement was found only with the three Penn-State equations, but two were biased according to Bland Altman analysis. The Penn-State equation from 1998 was the only valid predictive method, with a mean difference per day close to zero (+22 kcal), an excellent agreement (ICC 0.82) with 72% (n54/75) accurately assessed days (±10% of the measured EE) and with all patients within clinically acceptable levels, i.e. ±15% of the measured EE. During doubly labelled water period, observations were too few for any conclusive statement.
Conclusion: These data support use of the Penn-State equation from 1998 to estimate EE in patients with severe TBI while on mechanical ventilation.
Predicted energy expenditure, SenseWear Armband, Indirect calorimetry, Doubly labelled water, Traumatic brain injury
Nutrition and Dietetics Anesthesiology and Intensive Care Surgery Nursing
Research subject Anaesthesiology and Intensive Care; Nutrition; Caring Sciences in Medical Sciences
IdentifiersURN: urn:nbn:se:uu:diva-114123OAI: oai:DiVA.org:uu-114123DiVA: diva2:293083