P106 - PREDICTED ESTIMATES VERSUS MEASURED RESTING ENERGY REQUIREMENT IN PATIENTS WITH LIVER CIRRHOSIS

P106

PREDICTED ESTIMATES VERSUS MEASURED RESTING ENERGY REQUIREMENT IN PATIENTS WITH LIVER CIRRHOSIS

L. B. Larsen^1,2, A. S. Jørgensen^1,2, J. H. Jensen^1,2, T. Munk¹, L. Jensen¹, A. S. Teisner³, H. H. Rasmussen^1,4,5, A. W. Knudsen^1,*

¹The Dietitian and Nutritional Research Unit, EATEN, Copenhagen University Hospital – Herlev and Gentofte, Herlev, ²Department of Nursing and Nutrition, University College Copenhagen, Faculty of Health, Copenhagen, ³Department of Gastroenterology, Copenhagen University Hospital – Herlev and Gentofte, Herlev, ⁴Center for Nutrition and Intestinal Failure , Aalborg University Hospital, ⁵Danish Nutrition Science Center, Aalborg University, Aalborg, Denmark

Rationale: In patients with liver cirrhosis total energy requirement is recommended to be higher than in patients with other diseases. Previous studies have found limited agreement between measured and estimated energy expenditure, and limited knowledge of associations with patient characteristics exists. Therefore, guidelines recommend measurements of resting energy expenditure (REE) with indirect calorimetry (IC). The objective was to examine the agreement between measured-total energy expenditure (TEE) and predicted-TEE testing a variety of formulas. Further, to determine if the degree of agreement was associated with specific characteristics.

Methods: REE was measured by IC and converted to measured-TEE by an activity factor (AF). Predicted-TEE was calculated by Harris-Benedict (HB) and 27, 30 and 35 kcal/kg actual weight and adjusted body weight (ABW). Further data was collected on, anthropometry, vital values, blood samples, ascites, Child Pugh score, and AF.

Results: A total of 37 patients were included. IC measurements adjusted by AF was mean 27.8 ± 45.4 kcal/kg. Expressed by ± 10%, HB and 27 kcal/kg had highest agreement with measured-TEE equal to 40.5%. A significant negative correlation was found between the degree of agreement with HB, 30 and 35 kcal/kg ABW and heart rate (p<0.05). A negative correlation between temperature and degree of agreement with all tested variables was furthermore found (p<0.05,). Lastly, a negative correlation was found with Child Pugh points, when calculated by 30 kcal/kg ABW (p<0.05).

Conclusion: In patients with cirrhosis, the majority had their energy requirement either overestimated or underestimated, depending on the predicted TEE used. Negative correlations with the degree of agreement were found with heart rate, body temperature, and Child Pugh points.

Disclosure of Interest: None declared