PD279 - COMPARISON OF ENERGY REQUIREMENTS MEASURED BY INDIRECT CALORIMETRY AND PREDICTED BY THE PENN STATE EQUATION IN CRITICALLY ILL SEPTIC PATIENTS DURING THEIR ICU STAY.

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PD279

COMPARISON OF ENERGY REQUIREMENTS MEASURED BY INDIRECT CALORIMETRY AND PREDICTED BY THE PENN STATE EQUATION IN CRITICALLY ILL SEPTIC PATIENTS DURING THEIR ICU STAY.

R. Dunne1,*, K. Murphy 1, C. Twomey 1

1Department of Nutrition and Dietetics, Cork Univeristy Hospital , Cork, Ireland

 

Rationale: Sepsis can result in metabolic derangements leading to difficulties in accurately determining energy requirements (ER) in critically ill patients. Indirect calorimetry (IC) is the gold standard. However, predictive equations are often used to estimate ER. The Penn State (PSU) is reported to be the most accurate. The aim of this study is to determine if there is a significant difference between the estimated ER using PSU vs measured ER using IC in patients with sepsis during the course of their intensive care unit (ICU) stay.

Methods: This retrospective observational study included adults (≥16 years) diagnosed with sepsis in a mixed ICU of a large Irish teaching hospital between June 2022 and December 2025. Presence of sepsis was determined by identification of  sepsis on the admission or discharge document by a member of the medical team. ER was measured by IC and PSU equation during days 4–21 and expressed as kcal/kg/day. The statistical tests used were the paired t-test, Wilcoxon tests and bland-altman analysis.  Data was analysed by days: days 4–7, days 8–14, and days 15–21. Subgroup analysis compared patients admitted with sepsis to those who developed sepsis in ICU. Statistical significance was defined as p < 0.05.

Results: N = 130 patients  (70% male, mean BMI 28.4 kg/m², mean age 59.5 years).

ICU Day

4-7 (n=80)

8-14 (n=41)

15-21 (n=9)

IC kcals/kg/d (mean ± sd)

25.3 ± 6.0

25.1 ± 6.3

25.5 ± 2.5

PSU kcals/kg/d (mean ± sd) 

23.0 ± 3.6

23.8 ± 4.2

24.5 ± 3.7

P value

P<0.001

P=0.066

P=0.46

Conclusion: The PSU equation significantly underestimated energy expenditure during the first week of ICU stay. This highlights the importance of individualised nutrition using IC to avoid the complications of both under and over feeding, especially in the first week of ICU.

Disclosure of Interest: None declared