P547 - METABOLIC REQUIREMENTS AND NUTRITIONAL ACCURACY IN CRITICALLY INJURED PHYSICALLY FIT YOUNG ADULTS: THE VALUE OF INDIRECT CALORIMETRY

P547

METABOLIC REQUIREMENTS AND NUTRITIONAL ACCURACY IN CRITICALLY INJURED PHYSICALLY FIT YOUNG ADULTS: THE VALUE OF INDIRECT CALORIMETRY

D. Stein^1,*, D. weiner¹, V. tova¹, C. shaul¹, N. lev ran¹

¹nutrition, sheba, ramat gan, Israel

Rationale: Critically injured young adults exhibit pronounced metabolic disturbances, complicating precise nutritional therapy. This study aimed to evaluate whether the use of indirect calorimetry (IC) altered actual caloric and protein intake compared to standard ESPEN guidelines, and whether it reflects the elevated metabolic demands in this population

Methods: An observational study was conducted involving 22 critically injured young adults (mean age: 24.2 ± 9.6 years; mean BMI: 24.4 ± 3.3 kg/m²).     Resting metabolic rate (RMR) was measured via IC and normalized per kilogram of body weight (kcal/kg/day). Energy and protein intakes, also calculated per kilogram of body weight, were prescribed based on IC-derived measurements and compared to standard ESPEN guideline estimates (25 kcal/kg/day for energy; 1.5 g/kg/day for protein). In addition, biochemical assessments, including C-reactive protein, serum albumin, urea, and creatinine levels, were performed.

Results:  Measured RMR/kg (37.0 ± 11.1 kcal/kg/day) was significantly higher than ESPEN guideline estimates (p<0.001). Actual caloric intake guided by IC (33.0 ± 13.4 kcal/kg/day) was significantly greater and more precise than guideline-derived prescriptions (p=0.022). Similarly, actual protein intake (1.98 ± 0.50 g/kg/day) significantly exceeded ESPEN-recommended protein levels (p<0.001). Biochemical tests indicated ongoing inflammation and metabolic stress, confirming increased nutritional demands

Conclusion: ESPEN guidelines underestimated metabolic requirements in critically injured, young, physically fit patients. IC-directed nutritional support enabled significantly more accurate caloric and protein intakes. These results underscore the necessity of individualized metabolic assessment in critically injured populations, particularly those with higher physical fitness levels, to optimize clinical outcomes.

Disclosure of Interest: None declared