O064 - THE METABOLIC PHENOTYPE OF POST-ICU PATIENTS: ENERGY METABOLISM AFTER CRITICAL ILLNESS

O064

THE METABOLIC PHENOTYPE OF POST-ICU PATIENTS: ENERGY METABOLISM AFTER CRITICAL ILLNESS

E. Verheyen^1,2,*, L. Leemans^1,2,3,4, M. Aerts^1,2,4,5, P.-J. Cortoos^2,4,6, Z. Rosseel^1,4,6, E. De Waele^1,2,4

¹Department of Clinical Nutrition, Universitair Ziekenhuis Brussel (UZ Brussel), ²Faculty of Medicine and Pharmacy, ³Rehabilitation Research Department, ⁴Vitality Research Group, Vrije Universiteit Brussel (VUB), ⁵Department of Gastroenterology, ⁶Department of Pharmacy, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium

Rationale: Survivors of critical illness frequently experience metabolic alterations and nutritional challenges after ICU discharge. Knowledge of resting energy expenditure (REE) is essential for optimizing nutritional support, yet remains insufficiently characterized in post-ICU patients. Indirect calorimetry (IC) remains the golden standard for measuring REE. This study aimed to define the metabolic phenotype of post-ICU patients using published REE measurements by IC and compare these values with the reported REE of general ward patients.

Methods: A systematic review with meta-analysis was performed for post-ICU and general ward patient studies, reporting REE data measured by IC per kg bodyweight. Descriptive statistics and weighted independent t-tests were used to compare means, and an additional sensitivity analysis for age was performed, given the well-established decline in REE with increasing age. Variation was assessed using the coefficient of variation (CV). 

Results: Eleven studies were included, representing 578 patients (436 General vs 142 Post-ICU). Post-ICU patients had a higher REE than general patients (22.06 vs 21.24 kcal/kg, p<0.001). Inter-individual variability was high in both populations, ranging from 4.2 kcal/kg/day in post-ICU patients to 6.6 kcal/kg/day in general patients, and large CVs (respectively, 19% vs 21%) were observed. However, a sensitivity analysis for age yielded inconsistent results: after excluding studies that included only older populations (≥65 years), general patients had a higher REE (22.87 vs 22.06 kcal/kg, p<0.001), highlighting age as a critical confounder.

Conclusion: REE differences exist between post-ICU and general ward patients, although highly dependent on age. Given the inter-individual variability, predictive equations could be unreliable, and individualized metabolic assessment is required.

Disclosure of Interest: None declared