Measured energy expenditure in mildly hypothermic critically ill patients with traumatic brain injury: A sub-study of a randomized controlled trial

• Published in: Clinical nutrition (Edinburgh, Scotland) Scotland), 2021-06, Vol.40 (6), p.3875-3882
• Main Authors: Ridley, Emma J., Davies, Andrew R., Bernard, Stephen, McArthur, Colin, Murray, Lynne, Paul, Eldho, Trapani, Antony, Cooper, D James
• Format: Article
• Language: English
• Subjects: Critical illness; Energy expenditure; Enteral nutrition; Metabolism; Prophylactic hypothermia; Traumatic brain injury
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2021.05.012

Prophylactic hypothermia, often used in critically ill patients with traumatic brain injury, reduces energy expenditure and may affect energy delivered by nutrition therapy. The primary objective of this study was to measure energy expenditure in hypothermic patients over the first 3 days after traumatic brain injury (TBI). Secondary objectives included comparison of measured energy expenditure and nutrition delivery to day 7. A prospective sub-study of a randomized controlled trial conducted in patients with severe TBI, investigating prophylactic hypothermia (33–35 °C) as a neuroprotective therapy. In two centers, indirect calorimetry was initiated within 24 h of randomization and repeated up to twice daily to day 7. Data are presented as n (%), mean (standard deviation (SD)), median [interquartile range (IQR)], and mean difference (95% confidence interval (CI)). Forty patients were included (20 in each group), with 17 patients in the hypothermic and 16 in the normothermic group having an indirect calorimetry measurement in the first 3 days. Over the first 3 days, the mean temperature in the hypothermic and normothermic groups was 33.5 (0.6) ºC (n = 17) and 37 (0.5) ºC (n = 16), p