Harris-Benedict equation for critically ill patients: Are there differences with indirect calorimetry?

Abstract Purpose The aim of this study was to compare the measured energy expenditure (EE) and the estimated basal EE (BEE) in critically ill patients. Materials and Methods Seventeen patients from an intensive care unit were randomly evaluated. Indirect calorimetry was performed to calculate patien...

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Published in:Journal of critical care 2009-12, Vol.24 (4), p.628.e1-628.e5
Main Authors: Japur, Camila C., MSc, Penaforte, Fernanda R.O., MSc, Chiarello, Paula G., PhD, Monteiro, Jacqueline P., PhD, Vieira, Marta N.C.M., PhD, Basile-Filho, Anibal, PhD
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Algorithms
Basal Metabolism
Calorimetry, Indirect
Correction factors
Critical Care
Critical Illness
Cross-Sectional Studies
Data Interpretation, Statistical
Disease
Energy
Energy expenditure
Energy Metabolism
Guillain-Barre syndrome
Humans
Hypermetabolism
Hypometabolism
Indirect calorimetry
Intensive Care Units
Metabolism
Middle Aged
Patients
Pneumonia
Respiration, Artificial
Respiratory failure
Ventilators
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Summary:Abstract Purpose The aim of this study was to compare the measured energy expenditure (EE) and the estimated basal EE (BEE) in critically ill patients. Materials and Methods Seventeen patients from an intensive care unit were randomly evaluated. Indirect calorimetry was performed to calculate patient's EE, and BEE was estimated by the Harris-Benedict formula. The metabolic state (EE/BEE × 100) was determined according to the following criteria: hypermetabolism, more than 130%; normal metabolism, between 90% and 130%; and hypometabolism, less than 90%. To determine the limits of agreement between EE and BEE, we performed a Bland-Altman analysis. Results The average EE of patients was 6339 ± 1119 kJ/d. Two patients were hypermetabolic (11.8%), 4 were hypometabolic (23.5%), and 11 normometabolic (64.7%). Bland-Altman analysis showed a mean of −126 ± 2135 kJ/d for EE and BEE. Only one patient was outside the limits of agreement between the 2 methods (indirect calorimetry and Harris-Benedict). Conclusions The calculation of energy needs can be done with the equation of Harris-Benedict associated with lower values of correction factors (approximately 10%) to avoid overfeeding, with constant monitoring of anthropometric and biochemical parameters to assess the nutritional changing and adjust the infusion of energy.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2008.12.007