PD240 - MONITORING RESTING ENERGY EXPENDITURE DURING ICU STAY.

PD240

MONITORING RESTING ENERGY EXPENDITURE DURING ICU STAY.

P. C. Durelli^1,*, S. Gervasio¹, N. Milanesio¹, T. Catale¹, M. N. Petrachi¹, E. Favaro¹, D. Bonfanti¹, A. Pezzana¹

¹ASL Città di Torino, Torino, Italy

 

Rationale: International literature recommends a gradual progression to reach caloric and protein targets during Intensive Care Unit (ICU) stay¹. The use of indirect calorimetry (IC) to determine resting energy expenditure (REE) is recommended². This study aims to compare IC measurements during the first 2-3 days in ICU (T0) and after day 4 (T1).

Methods: From February 2024 until March 2026 patients in ICU(Nutric Score >5) were monitored by the Clinical Nutrition Unit. IC was performed at T0 and at T1. The data were analysed with descriptive and inferential statistics.

Results: 15 patients with an average age of 56 years old (4 female and 11 male) and an average body mass index (BMI) of 28.2 kg/m² were enrolled. At T0 the mean REE measurement with IC was 1480 ± 398 kcal/die (equal to 85% of REE estimated by Harris Benedict - HB - formula) and at T1 it was 1711 ± 470 kcal/die (equal to 98% of REE estimated by HB formula). The mean difference between the two measurements is 291 ± 193 kcal/die. The REE estimated by HB formula (1754 ± 282 kcal/die)  is higher then the REE measured by IC (1480 ± 398 kcal/die. 73.3% of patients enrolled showed an increase of REE between T0 anT1. We performed IC during the first three days and after the 4^th day on 47% of patients enrolled. The main reasons of delay were: deterioration of clinical conditions, surgery, death.

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Conclusion: IC measurements show an increase in the REE from T0 to T1, confirming data found in the scientific literature. Moreover, it showed the importance of performing IC after day 4 in order to provide the optimal nutritional therapy.

References: 1. Zanten A.R.H, et al, Nutrition therapy and critical illness: practical guidance for the ICU, post-ICU, and long-term convalescence phases, Critical Care, 2019.

2. Wischmeyer P.E. et al, Point-counterpoint: Indirect calorimetry is essential for optimal nutrition therapy in the intensive care unit, Nutr Clin Pract, 2021.

 

 

Disclosure of Interest: None declared