2000, Number 4
Comparative study of the Ireton-Jones equation and indirect calorimetry to estimate resting energy rate in surgical patients
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ABSTRACTObjective: To compare the Ireton-Jones equation and indirect calorimetry to estimate resting metabolic rate (RMR) in surgical patients.
Setting: Third level health care hospital.
Design: Prospective, comparative study. ANOVA and linear correlation coefficient were used, p ‹ 0.05.
Patients and methods: We estimated the resting metabolic rate (RMR) through the Ireto-Jones equation using parameters for patients without ventilatory support and through indirect calorimetry in patients hospitalised in the General Surgery Service from November 1996 to March 1998. Age, weight, size, body mass index (BMI) and diagnosis were considered. Indirect calorimetry was the golden standard. Patients were divided in 5 groups: Group I, severe acute pancreatitis; Group II, enterocutaneous fistulas; Group III, cancer patients; Group IV, sepsis; Group V, major surgery patients.
Results: We made 166 RMR determinations using the Ireton-Jones equation and calorimetry. Age of patients averaged 39.87 ± 14.41 years. Group I represented 40% of the determinations, group II, 31%; group III, 7%; group IV, 14%, and group V, 7%. RMR averaged 1505 ± 400 kcal/day as determined through calorimetry. Respiratory coefficient (RC) averaged 0.89 ± 0.14 and the non-proteic RC averaged 0.94 ± 0.16. The Ireton-Jones equation yielded a RMR of 1526 ± 247 kcal/day. Correlation coefficient for all groups was 0.6 (p = 0.0000). For Group I, it was 0.5 (p = 0.0000); for group II, 0.5 (p = 0.0019); for group III, 0.9 (p = 0.6659); for group IV, 0.7 (p = 0.3743); and group V, 0.7 (p = 0.3545). The percentage of variation was 2.46-22.3% for all groups
Conclusion: RMR determination by means of the Ireton-Jones equation is not statistically different from that obtained through indirect calorimetry in general populations, but is statistically different for specific groups of patients. Variations through the equation range from 2 to 22%. Indirect calorimetry remains the “Golden Standard” for RMR determination.
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