P615 - ESTIMATING ENERGY NEEDS IN OBESE ICU PATIENTS: A COMPARISON BETWEEN PREDICTIVE EQUATIONS AND INDIRECT CALORIMETRY

P615

ESTIMATING ENERGY NEEDS IN OBESE ICU PATIENTS: A COMPARISON BETWEEN PREDICTIVE EQUATIONS AND INDIRECT CALORIMETRY

N. Milanesio¹, M. Zanardi¹, L. De Carli^1,*, R. Scotto Busato¹, S. Gervasio¹, E. Nigro¹, A. Genovese¹, A. Trapani¹, A. Audi¹, P. Durelli¹, T. Catale¹, A. Pezzana¹

¹ASL Città di Torino, Torino, Italy

Rationale: Guidelines for determining caloric requirements in critically ill obese patients remain inconsistent.This study evaluates the accuracy of predictive equations by comparing them to Resting Energy Expenditure (REE) values obtained through indirect calorimetry (mREE) in ICU patients with obesity

Methods: 38 indirect calorimetry assessments were conducted using the “QNRGY plus” device in 24 mechanically ventilated obese patients in the intensive care unit. 4 measurements were excluded due to excessive variability in CO₂ or O₂ readings. For each assessment, three REE values were documented: mREE, predicted REE according to ESPEN guidelines (based on adjusted body weight) (ESPEN REE), and REE estimated using the Harris-Benedict formula with actual body weight (HB REE)

Results: Data normality was assessed using the Shapiro-Wilk test, which indicated a non-normal distribution (W = 0.92, P = 0.040). The Kruskal-Wallis test revealed significant differences among the three methods (P = 0.0027). Post-hoc analysis using Dunn’s test with Bonferroni correction found a statistically significant difference between mREE and ESPEN REE (P = 0.019). No significant difference was found between mREE and HB REE, nor between ESPEN REE and HB REE

Conclusion: Energy requirements estimated using adjusted body weight appear to diverge from directly measured REE values more than directly applying the HB formula on the real weight. Further research involving larger patient cohorts is warranted to validate these preliminary findings

Disclosure of Interest: None declared