Purpose Of Review: Review recent literature on the role of indirect calorimetry in critical care nutrition management.
Recent Findings: Critical illness demands objective, targeted nutritional therapy to prevent adverse effects of underfeeding/over feeding. Thus, all recent societal guidelines recommend indirect calorimetry use to determine energy needs. Very recently, indirect calorimetry technology has finally evolved to allow for accurate, simple, and routine utilization in a wider range of ICU patients. Recent data continues to confirm poor correlation between measured and equation-predicted energy expenditure emphasizing need for indirect calorimetry to be standard of care. This may be particularly true in COVID-19, where significant progressive hypermetabolism and variability in energy expenditure has been shown. Metabolic physiology can change frequently during ICU stay in response to changes in clinical condition or care. Thus, repeated longitudinal indirect calorimetry measures are needed throughout ICU stay to optimize care, with initial data showing improved clinical outcomes when indirect calorimetry targets are utilized.
Summary: Personalized ICU care demands objective data to guide therapy. This includes use of indirect calorimetry to determine energy expenditure and guide ICU nutrition therapy. Long-awaited new innovations in indirect calorimetry technology should finally lead to indirect calorimetry to becoming a fundamental component of modern ICU standard of care and clinical research moving forward.
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http://dx.doi.org/10.1097/MCC.0000000000000844 | DOI Listing |
Am J Physiol Endocrinol Metab
January 2025
Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands.
The Respiratory Exchange Ratio (RER), which is the ratio of total carbon dioxide produced over total oxygen consumed, serves as a qualitative measure to determine the substrate usage of a particular organism on the whole-body level. Quantification of RER by its direct conversion into %Glucose (%G) and %Lipid oxidation (%L) at a given timepoint can be done by utilizing nonprotein respiratory quotient tables. These tables, however, are limited to specific increments, and intermediate RER values are not covered by these tables.
View Article and Find Full Text PDFMol Metab
January 2025
Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Alabama at Birmingham, Birmingham, Alabama 35294, U.S.A; Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL 35294 U.S.A; UAB Comprehensive Diabetes Center. Electronic address:
Objective: Obesity-associated metabolic dysfunction is a major public health concern worldwide. Endothelial dysfunction is a hallmark of metabolic dysfunction, and endothelial cells affect metabolic functions. Because autophagy-related gene 7 (ATG7) is involved in various cellular physiology, we investigated the roles of endothelial cell-ATG7 (EC-ATG7) on high-fat diet-induced obesity and its related metabolic dysfunction.
View Article and Find Full Text PDFJ Sport Rehabil
January 2025
A.T. Still University, Mesa, AZ, USA.
Clinical Scenario: Critical appraisal of whole-body metabolism as a measure of concussion recovery is lacking in the available evidence. There has been extensive exploration of options for a gold standard assessment for concussion, including blood biomarkers, electroencephalogram, and neuroimaging, but none have yet to demonstrate good empirical evidence of efficacy.
Clinical Question: In patients with sport-related concussion (SRC), can resting metabolic rate (RMR), as measured through indirect calorimetry, be used as a physiologic assessment of recovery?
Summary Of Key Findings: Three studies demonstrated relevance to the clinical question.
We recently reported that a chimeric peptide (GEP44) targeting the glucagon-like peptide-1 receptor (GLP-1R) and neuropeptide Y1- and Y2-receptors decreased body weight (BW), energy intake and core temperature in diet-induced obese (DIO) male and female mice. Given that GEP44 was found to reduce core temperature (surrogate measure of energy expenditure (EE)) in DIO mice, we hypothesized that GEP44 would reduce EE in male and female high fat diet (HFD)-fed rats. To test this, rats were maintained on a HFD for at least 4 months to elicit DIO prior to undergoing a sequential 2-day vehicle period, 2-day GEP44 (50 nmol/kg) period and a minimum 2-day washout period and detailed measures of energy homeostasis.
View Article and Find Full Text PDFAsia Pac J Clin Nutr
February 2025
Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. Email:
Background And Objectives: This study aimed to investigate the respiratory quotient (RQ) levels and its trend in the early postoperative period of patients with heart disease. Additionally, we explored factors influencing RQ and evaluated the predictive capabilities of RQ and lactic acid for various outcomes.
Methods And Study Design: In this prospective observational study, participants included were heart disease patients aged 18-80 years who underwent elective open-heart surgery and were subsequently admitted to the cardiothoracic surgery ICU post-operation.
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