Sep 5, 2026
2:00 PM12:00 PM
ePoster display
PD233
INDIRECT CALORIMETRY VERSUS PREDICTIVE METHODS FOR DETERMINING ENERGY REQUIREMENTS IN CRITICALLY ILL ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
J. Y. Jeong1, J. G. Lee2,*, S. M. Baik2, H. J. Shim2
1Clinical Nutrition, 2Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea, Republic Of
Rationale: Energy expenditure in critically ill patients varies over time, making accurate estimation difficult. Indirect calorimetry (IC) is considered the reference method, but its impact compared with predictive or weight-based methods remains uncertain.
Methods: We performed a systematic review of PubMed and KoreaMed (2010–2025). Randomized controlled trials comparing IC-guided energy determination with predictive equations or weight-based methods in critically ill adults were included. Random-effects meta-analysis was conducted. Effect estimates for binary outcomes were expressed as risk ratios (RRs). Outcomes included energy delivery, energy balance, mortality, infections, and length of stay.
Results: Eight randomized trials were included. Estimated energy requirement did not differ significantly between groups (mean difference [MD] 25.6 kcal/day, 95% confidence interval [CI] –156.5 to 207.7). Delivered energy was higher with IC (MD 406.7 kcal/day, 95% CI –7.7 to 821.1), with a trend toward improved energy balance (MD 343.9 kcal/day, 95% CI –44.1 to 731.9). No significant differences were observed in ICU mortality (RR 1.00, 95% CI 0.74–1.35), hospital mortality, infections, or ICU length of stay. Hospital length of stay (MD 2.0 days, 95% CI 0.6–3.3) and duration of mechanical ventilation (MD 0.9 days, 95% CI 0.1–1.7) were longer in the IC group.
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Conclusion: IC improves alignment between energy delivery and measured requirements but does not improve major clinical outcomes. IC remains the most accurate method when available, while alternative methods may be used when IC is not feasible.
Disclosure of Interest: None declared