P168 - COMPARISON BETWEEN MEASURED AND ESTIMATED ENERGY EXPENDITURE IN CANCER PATIENTS ADMITTED TO AN INTENSIVE CARE UNIT

P168

COMPARISON BETWEEN MEASURED AND ESTIMATED ENERGY EXPENDITURE IN CANCER PATIENTS ADMITTED TO AN INTENSIVE CARE UNIT

I. A. D. O. Medeiros^1,*, J. M. Toloi², A. C. G. Laranja², P. G. do Carmo², T. M. Borges², J. M. Silva Júnior¹

¹Anestesiology, University of São Paulo, São Paulo, ²Nutrition, Barretos Cancer Hospital, Barretos, Brazil

Rationale: To compare resting energy expenditure measured by IC in a population of cancer patients admitted to an intensive care unit with the goals recommended by the American (ASPEN) and European (ESPEN) guidelines for nutritional therapy in critically ill patients.

Methods: The calculation of the goals was performed according to the recommendations of ESPEN (2023) and ASPEN (2021). The intraclass correlation coefficient (ICC) was used to test the reproducibility of the goals in relation to IC. The lack of agreement between the measured and estimated energy expenditure was analyzed and plotted according to Bland Altman.

Results: Indirect calorimetry (IC) was performed in the first week of ICU for most patients (79.6%). The mean resting energy expenditure of IC was 1542 ± 390 kcal/day (22 kcal/kg), the mean respiratory quotient was 0.77. The REE estimation formulas that most closely approximate the REE-CI, presenting a moderate correlation, were: 25 kcal/kg ABW ESPEN (ICC 0.714), 25 kcal/kg ESPEN (ICC 0.707), 20 kcal/kg ASPEN (ICC 0.698), 25 kcal/kg ASPEN (ICC 0.671) and 20 kcal/kg ESPEN (ICC 0.616).

Conclusion: There was no correlation between energy expenditure measured by indirect calorimetry and the weight-based equations recommended by the guidelines.

References:         1.  Singer P, Blaser AR, Berger MM, Calder PC, Casaer M, Hiesmayr M, et al. ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit. Clinical Nutrition. 2023 Sep 1;42(9):1671–89. 

        2.  Compher C, Bingham AL, McCall M, Patel J, Rice TW, Braunschweig C, et al. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition. Journal of Parenteral and Enteral Nutrition [Internet]. 2022;46(1):12–41. Available from: https://aspenjournals.onlinelibrary.wiley.com/doi/abs/10.1002/jpen.2267

Disclosure of Interest: None declared