O019 - ENERGY EXPENDITURE DURING CRITICAL ILLNESS AND RECOVERY

O019

ENERGY EXPENDITURE DURING CRITICAL ILLNESS AND RECOVERY

A. Lozovskyte^1,2,*, E. Salciute-Simene^1,2, M. Gudynaite², A. Kurdian², I. Gervelyte², K. Varzinskas^1,2, E. Januskeviciute^1,2, G. Patapaviciute¹, R. Kuprys^1,2, A. Klimasauskas^1,2, J. Sipylaite^1,2

¹Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania, ²Vilnius University, Faculty of Medicine, Vilnius, Lithuania

Rationale: Energy expenditure (EE) in critically ill patients remains a poorly understood topic. It is recognized that EE changes during the course of the disease, however only few publications focus on revealing longitudinal EE changes. We aimed to investigate EE changes during the early phase in ICU, late phase in ICU, and post-ICU (recovery) phase.

Methods: A prospective observational study of mechanically ventilated ICU patients. EE was measured via indirect calorimetry (GE Q-NRG+) for up to 10 days in early phase, weekly in late phase, and post-ICU. Adjusted body weight was used in overweight patients. Body composition was assessed by bioelectrical impedance (InBody S10®), muscle mass measurements were corrected for fluid overload. Data were analyzed using SPSS with paired-samples t-tests and Spearman correlation. 

Results: 57 patients (425 EE measurements) were included. Mean age was 61±15 years; BMI 29±8; APACHE II 21±8. Early phase EE averaged 23.5±3.96 kcal/kg. Late phase EE was 20.3±3.47 kcal/kg, and recovery phase was 27.5±3.85 kcal/kg. EE was significantly higher in recovery compared to early phase (p<0.0001). A high degree of interpatient variability was observed: 76.8% had EE <24 kcal/kg, 10.7% had EE 24–26 kcal/kg, and 12.5% had EE >26 kcal/kg. Investigating individual factors affecting energy expenditure, EE was negatively correlated with age (r= -0.35, p<0.05). Sex did not have any impact. Body composition measures (muscle mass and body fat) did not demonstrate any correlation with EE.

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Conclusion: Early ICU phase measurements revealed EE of 23.5±3.85, which is reasonably close to ESPEN's recommended target of 25 kcal/kg; however due to individual variation only 11% of patients would be adequately fed with this calculation. Increased EE during recovery supports the need for continued nutritional monitoring post-ICU.

Disclosure of Interest: None declared