Energy expenditure and indirect calorimetry in critical illness and convalescence: current evidence and practical considerations

Energy expenditure appears highly variable among critically ill patients and in individual patients during various phases of illness. As a consequence, critically ill patients are at considerable risk of under- or overfeeding during ICU and post-ICU hospital stay, when rough and static estimates are used. The most recent international guidelines recommend regular indirect calorimetry to measure energy expenditure as a proxy for caloric requirement in ICU patients.

However, the superiority of IC-guided nutritional therapy has not yet been unequivocally proven in randomized clinical trials and further research is urgently warranted.

Nevertheless, IC has strong theoretical potential to improve nutritional status and consequently, the long-term outcome of critically ill patients in the various metabolic phases of critical illness.

Increased knowledge of practical use and theoretical benefits of IC among clinicians can contribute to more widespread and routine use, thereby promoting research opportunities and real-time targeted and personalized nutrition therapy.

Article details:

- Title: Energy expenditure and indirect calorimetry in critical illness and convalescence: current evidence and practical considerations
- Authors: Hanneke Pierre Franciscus Xaverius Moonen, Karin Josephina Hubertina Beckers and Arthur Raymond Hubert van Zanten
- Published in: Journal of Intensive Care (2021) 9:8
- Link: https://doi.org/10.1186/s40560-021-00524-0