The implementation of indirect calorimetry for patients with acute respiratory failure: Invited commentary on techniques and procedure

Respiratory failure is a critical condition that occurs when the lungs cannot provide sufficient oxygen to the blood or effectively remove carbon dioxide from the body.

Patients with respiratory failure often struggle to maintain adequate oral nutrition due to associated breathlessness, placing them at greater risk for malnutrition due to both their metabolic response to stress and their reliance on nutritional support.

While predictive equations are commonly used to estimate the energy (caloric) needs of these patients, they are often inaccurate, complex, and difficult to apply. Recent advancements in technology have made it possible to measure energy needs at the bedside using indirect calorimetry (IC).

This review aims to explore how IC can impact clinical decision-making and nutrition care for mechanically ventilated patients with respiratory failure. It also provides examples of how IC is implemented in both a large tertiary care hospital and a small community hospital, alongside strategies for its successful integration into clinical practice.