PP156 - MEASURED VERSUS PREDICTED ENERGY EXPENDITURE IN ICU SURVIVORS
PP156
MEASURED VERSUS PREDICTED ENERGY EXPENDITURE IN ICU SURVIVORS
E. Kuksi Celina1,*, S. Voussure1, B. Lambermont2, R. Anne-Françoise2
1Dietetics, 2Intensive Care, University Hospital of Liège, Liège, Belgium
Rationale: Energy requirements during post-ICU recovery are poorly defined. This study aimed to compare energy expenditure (EE) measured by indirect calorimetry (IC) with values predicted by commonly used equations and with actual energy intake 3 months after ICU discharge.
Methods: Adults attending a post-ICU dietetic consultation 3 months after ICU discharge were included if cooperative, off oxygen supply, and not claustrophobic. Resting EE was measured by IC (Q-NRG, Cosmed) and was corrected for non-fasting status (+10%) and physical activity level (PAL) to obtain the measured TEE (mTEE). Measurement lasted at least 20 min. Henry, Harris–Benedict, and Mifflin formulas were used to predict TEE, applying the same correction for PAL. Body weight selection (actual, ideal, or adjusted) depended on body mass index (BMI). Energy intakes were assessed by 24-hour dietary recall.
Results: Thirty-seven patients (age 58 [46.5–71] years, 29.7% women, BMI 26 [22.6–27.7] kg/m², SAPS II 25 [18.5–39]) were evaluated 93 [85–100] days after 9 [7–14.5]-day ICU stay. PAL was estimated as 1.4 (1.4-1.4). Energy intakes (1948 [1613–2468] kcal/day) were significantly lower than mTEE that reached 2296 [1906–2740] kcal/day or 30.9 [28.3–37.2] kcal/kg/day (p = 0.0086). In 11/37 (29.7%) patients, mTEE was ≥ 35 kcal/kg/day. None of the predicted TEE aligned with mTEE, respectively 2173 (1863-2506) kcal/day for Henry (p = 0.0155), 1536(1319-1791) kcal/day for Harris–Benedict (p < 0.0001), and 2094 (1793-2363) kcal/day for Mifflin (p < 0.0001).
Conclusion: Three months after ICU discharge, mTEE differed from all predictive equations, which underestimated patients’ energy requirements. Energy intake did not reach the energy requirements. Measured TEE was closer to 30 kcal/kg/day than to the commonly suggested 35 kcal/kg/day target, highlighting the variability of energy needs during post-ICU recovery and the limited accuracy of predictive equations.
Disclosure of Interest: None declared