medigraphic.com

2024, Number 6

<< Back Next >>

Med Crit 2024; 38 (6)

Indirect calorimetry versus calculation of caloric requirement by measurement of MVCO2 given by mechanical ventilator

Chávez DGR, Dector LDM, Enríquez SD, Alva AN, Mercado CE

Language: Spanish
References: 39
Page: 478-485
PDF size: 308.73 Kb.


ABSTRACT

Introduction: monitoring critically ill patients requires optimal monitoring of energy requirements to determine the ideal nutritional intake according to the clinical condition, support early improvement, and reduce complications. Caloric requirements depend on the individual characteristics of each patient, such as pathology, and sedation, among others. Over time, several techniques have been developed to determine this requirement, such as the one calculated from MVCO2, a parameter provided by the mechanical ventilator, to continuous indirect calorimetry, the latter being the gold standard for this purpose. Objective: to compare the measurement of basal energy requirement obtained by indirect calorimetry in patients with invasive ventilatory support and the energy requirement calculated from MVCO2 measured with a Drager ventilator in patients with invasive ventilatory support. Material and methods: a prospective cross-sectional study was developed in the Intensive Care Unit of the Dalinde Medical Center. It included patients with advanced airway support who had indirect calorimetry software and ventilation support provided by a Drager ventilator with MVCO2 measurement, with which the caloric requirement calculation was performed. Results: the energy requirement calculated by MVCO2 was 141.35 ± 32, and given by indirect calorimetry was 141.67 ± 26.5. A difference of means analysis was performed for both methods and did not find statistically significant differences (p-value of 0.907 and p-value of 0.091). Conclusion: there is a percentage relationship between the data from energy requirement calculated by indirect calorimetry and calculated from the production of MVCO2 by the Draguer ventilator. Therefore, calculating the caloric requirement by measuring MVCO2 given by a mechanical ventilator is an adequate alternative for critically ill patients hospitalized in units that do not have indirect calorimetry.


REFERENCES

  1. Achamrah N, Delsoglio M, De Waele E, Berger MM, Pichard C. Indirect calorimetry: the 6 main issues. Clin Nutr. 2021;40(1):4-14. Available in: https://pubmed.ncbi.nlm.nih.gov/32709554/. https://doi.org/10.1016/j.clnu.2020.06.024 0261

  2. Delsoglio M, Achamrah N, Berger MM, Pichard C. Indirect calorimetry in clinical practice. J Clin Med. 2019;8(9):1387. doi: 10.3390/jcm8091387. Available in: https://pubmed.ncbi.nlm.nih.gov/31491883/

  3. Saw Kian C, Department of Anaesthesiology & Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. A comparison between continuous indirect calorimetry and single weight-based formula in estimating resting energy expenditure in nutritional therapy: a prospective randomized controlled study in critically ill patients. Med Health Dec. 2021;16(2):207-215. Available in: https://journalarticle.ukm.my/18277/1/15_ms0520_pdf_12714.pdf

  4. Murray G, Thomas S, Dunlea T, Nahikiasn-Nelm M, Roberts K. Predictive energy equations are correlated with indirect calorimetry in critical care: is correlation good enough? J Acad Nutr Diet. 2022;122(9):A24. Available in: http://dx.doi.org/10.1016/j.jand.2022.06.088

  5. Pizarro Gómez CE, Dueñas Castell C, Nieto Estrada VH, Gil Valencia BA, Durán Pérez JC, Ferrer Zaccaro L, et al. Consenso colombiano de criterios de ingreso a cuidados intensivos: Task force de la Asociación Colombiana de Medicina Crítica y Cuidados Intensivos (AMCI®). Acta Colomb Cuid Intensivo. 2023;23(2):202-228. Disponible en: http://dx.doi.org/10.1016/j.acci.2023.04.008

  6. Gostynska A, Stawny M, Dettlaff K, Jeli?ska A. Clinical nutrition of critically ill patients in the context of the latest ESPEN guidelines. Medicina (Kaunas). 2019;55(12):770. Available in: https://pubmed.ncbi.nlm.nih.gov/31810303/ http://dx.doi.org/10.3390/medicina55120770

  7. Gunst J, Van den Berghe G. Intensive care nutrition and post-intensive care recovery. Crit Care Clin. 2018;34(4):573-583. Available in: https://pubmed.ncbi.nlm.nih.gov/30223995/ https://doi.org/10.1016/j.ccc.2018.06.004

  8. Berger MM, Shenkin A, Schweinlin A, Amrein K, Augsburger M, Biesalski H-K, et al. ESPEN micronutrient guideline. Clin Nutr. 2022;41(6):1357-1424. Available in: https://pubmed.ncbi.nlm.nih.gov/35365361/ https://doi.org/10.1016/j.clnu.2022.02.015

  9. Mart MF, Girard TD, Thompson JL, Whitten-Vile H, Raman R, Pandharipande PP, et al. Nutritional Risk at intensive care unit admission and outcomes in survivors of critical illness. Clin Nutr. 2021;40(6):3868-3874. Available in: https://pubmed.ncbi.nlm.nih.gov/34130034/ https://doi.org/10.1016/j.clnu.2021.05.005

  10. Pizarro GCE, Durán JC, Nieto EVH, Gil VBA, Ferrer ZL, Dueñas CC, et al. Consenso colombiano de calidad en cuidados intensivos: task force de la Asociación Colombiana de Medicina Crítica y Cuidados Intensivos (AMCI®). Acta Colomb Cuid Intensivo. 2023;23(2):164-201. Disponible en: http://dx.doi.org/10.1016/j.acci.2023.04.007

  11. Reignier J, Boisramé-Helms J, Brisard L, Lascarrou J-B, Ait Hssain A, Anguel N, et al. Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). Lancet. 2018;391(10116):133-143. Available in: https://pubmed.ncbi.nlm.nih.gov/29128300/ http://dx.doi.org/10.1016/S0140-6736(17)32146-3

  12. Xu E, Tejada S, Solé-Lleonart C, Campogiani L, Valenzuela-Sanchez F, Koulenti D, et al. Evaluation of the quality of evidence supporting guideline recommendations for the nutritional management of critically ill adults. Clin Nutr ESPEN. 2020;39:144-149. Available in: https://pubmed.ncbi.nlm.nih.gov/32859308/. http://dx.doi.org/10.1016/j.clnesp.2020.07.004

  13. Vaquerizo-Alonso C, Bordejé-Laguna L, Fernández-Ortega JF, Bordejé-Laguna ML, Fernández-Ortega JF, García de Lorenzo y Mateos A, et al. Recomendaciones para el tratamiento nutrometabólico especializado del paciente crítico: introducción, metodología y listado de recomendaciones. Grupo de Trabajo de Metabolismo y Nutrición de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC). Med Intensiva. 2020;44:1-14. Disponible en: http://dx.doi.org/10.1016/j.medin.2020.02.008

  14. Álvarez J, Lallena S, Bernal M. Nutrición y pandemia de la COVID-19. Medicine. 2020;13(23):1311-1321. Disponible en: http://dx.doi.org/10.1016/j.med.2020.12.013

  15. Herrero Meseguer JI, Lopez-Delgado JC, Martínez García MP. Recomendaciones para el tratamiento nutrometabólico especializado del paciente crítico: indicaciones, momento de inicio y vías de acceso. Grupo de Trabajo de Metabolismo y Nutrición de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC). Med Intensiva. 2020;44:33-38. doi: 10.1016/j.medin.2019.12.017. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32532408

  16. Schorghuber M, Fruhwald S. Effects of enteral nutrition on gastrointestinal function in patients who are critically ill. Lancet Gastroenterol Hepatol. 2018;3(4):281-287. doi: 10.1016/S2468-1253(18)30036-0 Available in: https://pubmed.ncbi.nlm.nih.gov/29533200/.

  17. Compher C, Bingham AL, McCall M, Patel J, Rice TW, Braunschweig C, et al. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: the American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2022;46(1):12-41. doi: 10.1002/jpen.2267. Available in: https://pubmed.ncbi.nlm.nih.gov/34784064/.

  18. Pérez-Cordón L, Yébenes JC, Martínez de Lagrán I, Campins L. Transition from total parenteral nutrition to enteral nutrition in critically ill patients in Spain: a national survey. Med Intensiva. 2022;46(8):475-477. doi: 10.1016/j.medine.2022.06.003. Available in: https://pubmed.ncbi.nlm.nih.gov/35760732/

  19. Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48-79. doi: 10.1016/j.clnu.2018.08.037. Available in: https://pubmed.ncbi.nlm.nih.gov/30348463

  20. Yébenes J, Campins L, Martínez de Lagran I, Bordeje L, Lorencio C, Grau T, et al. Nutritrauma: a key concept for minimising the harmful effects of the administration of medical nutrition therapy. Nutrients. 2019;11(8):1775. doi: 10.3390/nu11081775. Available in: https://pubmed.ncbi.nlm.nih.gov/31374909

  21. Moya-Moya AJ, López-García MC, Sirvent-Segovia AE, Jiménez-Martínez CM, Ruiz de Assín Valverde A, Madrona-Marcos FM, et al. Percepción de conocimiento sobre Nutrición Clínica hospitalaria en los médicos residentes de un hospital terciario. Endocrinol Diabetes Nutr. 2022;69(4):247-253. Disponible en: http://dx.doi.org/10.1016/j.endinu.2021.03.002.

  22. Seres D, Parsons PE, Finlay G. Soporte nutricional en pacientes críticos: una visión general. Update Revisión de la literatura actual hasta: abril de 2023. [Consultada 24 mayo 2023] Última actualización de este tema: 06 de febrero de 2023.

  23. Mason JB. Principios nutricionales y evaluación del paciente con problemas digestivos. Nutrición en Gastroenterología. Parte II, Pág.: 52-73. Elsevier España. 2022.

  24. De Waele E, Jonckheer J, Wischmeyer PE. Indirect calorimetry in critical illness: a new standard of care? Curr Opin Crit Care. 2021;27(4):334-343. doi: 10.1097/MCC.0000000000000844 Available in: https://pubmed.ncbi.nlm.nih.gov/33990505

  25. Moonen HPFX, Beckers KJH, van Zanten ARH. Energy expenditure and indirect calorimetry in critical illness and convalescence: current evidence and practical considerations. J Intensive Care. 2021;9(1):8. Available in: https://pubmed.ncbi.nlm.nih.gov/33436084/ https://doi.org/10.1186/s40560-021-00524-0

  26. Landi Degl'Innocenti E. Termometria e calorimetria. In: Egidio Landi Degl'Innocenti. Elementi di meccanica dei fluidi, termodinamica e fisica statistica. Milano: Springer Milan; 2019. p. 81-110. Available in: https://doi-org.pbidi.unam.mx:2443/10.1007/978-88-470-3991-9_4

  27. Kopp Lugli A, de Watteville A, Hollinger A, Goetz N, Heidegger C. Medical nutrition therapy in critically ill patients treated on intensive and intermediate care units: a literature review. J Clin Med. 2019;8(9):1395. doi: 10.3390/jcm8091395. Available in: https://pubmed.ncbi.nlm.nih.gov/31500087

  28. Kaiyala KJ, Wisse BE, Lighton JRB. Validation of an equation for energy expenditure that does not require the respiratory quotient. PLoS One [Internet]. 2019;14(2):e0211585. Available in: http://dx.doi.org/10.1371/journal.pone.0211585

  29. Tah PC, Lee Z-Y, Poh BK, Abdul Majid H, Hakumat-Rai V-R, Mat Nor MB, et al. A single-center prospective observational study comparing resting energy expenditure in different phases of critical illness: Indirect calorimetry versus predictive equations. Crit Care Med. 2020;48(5):e380-390. doi: 10.1097/CCM.0000000000004282 Available in: https://pubmed.ncbi.nlm.nih.gov/32168031

  30. Koekkoek WAC, Xiaochen G, van Dijk D, van Zanten ARH. Resting energy expenditure by indirect calorimetry versus the ventilator-VCO2 derived method in critically ill patients: The DREAM-VCO2 prospective comparative study. Clin Nutr ESPEN. 2020;39:137-143. doi: 10.1016/j.clnesp.2020.07.005 Available in: https://pubmed.ncbi.nlm.nih.gov/32859307

  31. Achamrah N, Oshima T, Genton L. Innovations in energy expenditure assessment. Curr Opin Clin Nutr Metab Care. 2018;21(5):321-328. doi: 10.1097/MCO.0000000000000489 Available in: https://pubmed.ncbi.nlm.nih.gov/29912811

  32. Rattanachaiwong S, Singer P. Indirect calorimetry as point of care testing. Clin Nutr. 2019;38(6):2531-2544. doi: 10.1016/j.clnu.2018.12.035 Available in: https://pubmed.ncbi.nlm.nih.gov/30670292

  33. Slingerland-Boot H, Adhikari S, Mensink MR, van Zanten ARH. Comparison of the Beacon and Quark indirect calorimetry devices to measure resting energy expenditure in ventilated ICU patients. Clin Nutr ESPEN. 2022;48:370-377. doi: 10.1016/j.clnesp.2022.01.015 Available in: https://pubmed.ncbi.nlm.nih.gov/35331516

  34. Delsoglio M, Dupertuis YM, Oshima T, van der Plas M, Pichard C. Evaluation of the accuracy and precision of a new generation indirect calorimeter in canopy dilution mode. Clin Nutr. 2020;39(6):1927-1934. doi: 10.1016/j.clnu.2019.08.017 Available in: https://pubmed.ncbi.nlm.nih.gov/31543335

  35. Wischmeyer PE, Molinger J, Haines K. Point-counterpoint: indirect calorimetry is essential for optimal nutrition therapy in the intensive care unit. Nutr Clin Pract. 2021;36(2):275-281. doi: 10.1002/ncp.10643. Available in: https://pubmed.ncbi.nlm.nih.gov/33734477

  36. Berger MM, Pichard C. Feeding should be individualized in the critically ill patients. Curr Opin Crit Care. 2019;25(4):307-313. doi: 10.1097/MCC.0000000000000625 Available in: https://pubmed.ncbi.nlm.nih.gov/31145118

  37. Leyes P, Forga M, Herrero I. Capítulo 69: Soporte nutricional. Atención a las diversas patologías en la unidad de cuidados intensivos. Elsevier. España. 2024.

  38. Arroyo-Sánchez AS. Calorimetría indirecta en cuidado crítico: una revisión narrativa. Rev Nutr Clin Metab. 2020;3(2):45-56. doi: https://doi.org/10.35454/rnmc.v3n2.88. Disponible en: https://revistanutricionclinicametabolismo.org/index.php/nutricionclinicametabolismo/article/view/88

  39. Oshima T, Graf S, Heidegger CP, Genton L, Pugin J, Pichard C. Can calculation of energy expenditure based on CO2 measurements replace indirect calorimetry? Critical Care. 2017;21(1). doi: 10.1186/s13054-016-1595-8. Available in: https://pubmed.ncbi.nlm.nih.gov/28107817




2020     |     www.medigraphic.com