Monitoring energy metabolism with indirect calorimetry: instruments, interpretation, and clinical application.

Indirect calorimetry is the best measure to guide calorie administration during nutrition support. This article presents an update of the types of currently available indirect calorimeters and reviews the recent advances that guide the clinical application of indirect calorimetry. The emphasis of this report is placed on issues that the practicing clinician can use to evaluate, interpret, and apply measurements of energy expenditure.

Nutrition assessment and management of left ventricular assist device patients.

Nutrition evaluation and support is an integral component of left ventricular assist device (LVAD) therapy. Malnutrition in the LVAD patient contributes to a host of post-operative problems, such as infection and limited functional capacity, which compromise long-term outcomes. Comprehensive pre-operative evaluation of the LVAD patient should include a nutrition assessment and formalized plan to initiate and advance nutrition support while addressing the metabolic imbalances associated with heart failure.