Nutritional optimisation is recognised as having significant impact on clinical and functional outcomes of critically ill patients.   Clinical recommendations suggest use of indirect calorimetry guided nutrition in the intensive care unit (ICU), and a recent systematic review demonstrated improved outcomes from its use.   The COVID-19…

In this new review, the authors identify the pros and cons of Indirect Calorimetry (IC) to estimate Resting Energy Expenditure (REE) and define individual nutritional energy targets among critically ill patients.  Indirect Calorimetry (IC) is a monitoring tool that provides factual information on metabolism. There is significant evidence…

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 r…

Different metabolic phases can be distinguished in critical illness, which influences nutritional treatment. Achieving optimal nutritional treatment during these phases in critically ill patients is challenging. The aim of this observational study is to describe measured resting energy expenditure (mREE) and feeding practices and tolerance during…

Indirect calorimetry (IC)-guided nutrition might positively affect the clinical outcome of critically ill patients. The objective of this study is to assess the benefit of isocaloric nutrition guided by IC, compared to hypocaloric nutrition, for critically ill patients admitted to the intensive care unit (ICU). This systematic review and meta-ana…

COVID-19 can rapidly progress into acute respiratory distress syndrome accompanied by multi-organ failure requiring invasive mechanical ventilation and critical care treatment. Nutritional therapy is a fundamental pillar in the management of hospitalized patients. It is broadly acknowledged that overfeeding and underfeeding of intensive care unit…

Among other important risk factors for severe COVID-19 outcomes, obesity has emerged along with undernutrition-malnutrition as a strong predictor of disease risk and severity. Obesity-related excessive body fat may lead to respiratory, metabolic and immune derangements potentially favouring the onset of COVID-19 complications. Early after the ons…

Indirect calorimetry (IC) is the gold-standard for determining measured resting energy expenditure (mREE) in critical illness. When IC is not available, predicted resting energy expenditure (pREE) equations are commonly utilized, which often inaccurately predict metabolic demands leading to over- or under-feeding. This study aims to longitudinall…

Critical illness demands objective, targeted nutritional therapy to prevent adverse effects of underfeeding/ over feeding. Thus, all recent societal guidelines recommend indirect calorimetry use to determine energy needs. Current commercially available indirect calorimeters are often inaccurate, and the inconveniences have led to significant chal…

A major driver leading to the lack of emphasis on timely ICU nutrition delivery is lack of objective data to guide nutrition care. If we are to ultimately overcome current fundamental challenges to effective ICU nutrition delivery, we must all adopt routine objective, longitudinal measurement of energy targets via indirect calorimetry (IC). Key e…

The current review aims to summarize the complex relationship between SARS-CoV-2 infection and nutritional status and the effects of malnutrition in terms of disease severity, patients’ recovery time, incidence of complications and mortality rate. In COVID-19, this relationship has shown to be crucial across the disease phases, particularly in pe…

Nutritional and metabolic disturbances are observed in patients critically ill with COVID-19. At each step of the progression of the disease, ICU patients with COVID-19 should be carefully evaluated in terms of malnutrition risk and medical nutritional support. The tremendous challenges posed by the continuous clinical changes requires adequate a…

The use of indirect calorimetry (IC) is increasing due to its precision in resting energy expenditure (REE) measurement in critically ill patients. Thus, this study aim to evaluate the clinical outcomes of an IC-guided nutrition therapy compared to predictive equations strategy in such a patient population. This systemic review and meta-analysis…

This review article summarizes current evidence supporting the role of higher protein intakes, especially during the early phases of nutrition therapy in acute illness, methods for assessing protein requirements, as well as, the currently available high-protein enteral and parenteral nutrition solutions.  There is sufficient evidence (albeit limi…

The purpose of this methodology paper is to provide practical guidance to health professionals to perform this measurement safely, using various metabolic monitors. Indirect calorimetry is the best tool to assess resting energy expenditure in critically ill patients and ESPEN as well as ASPEN societies recommend its use. Nevertheless, the use of…

A new paper on Clinical Nutrition focused on the decision-making process around IC application for prescription, and individual optimisation of nutritional therapy. Optimal nutritional therapy requires an individually adapted provision of energy as close as possible to patient's real energy expenditure (EE). Indirect calorimetry (IC) is the gold…

The present guideline is an update and extension of the previous ESPEN guidelines on enteral nutrition (EN) and parenteral nutrition (PN) in adult critically ill patients published in 2006 and 2009, respectively. Since then, the ESPEN methodology has been upgraded resulting in rigorous evidence-based and consensus-based recommendations. The best…

A new key paper on Clinical Nutrition focused on the decisive role of Indirect calorimetry (IC) in clinical settings. IC has been long recognized as the gold standard for assessing basal or resting energy expenditure (REE) and determining energy requirement is a fundamental of nutrition support, particularly in the situation where adjustment of e…

This observational cohort study over two 3 months periods aims to observe the impact of reduced recommended energy targets and the absence of ICU dietitians on nutrient prescription and clinical outcome. The most important result is that a reduction in energy target in ICU resulted in a predictable but unnoticed reduction of protein delivery. In…

This review focuses on why indirect calorimetry should be used in clinical practice of critical care medicine and which are the benefits of using indirect calorimetry and which are the disadvantages of using predictive equation. Considering that "The energy prescription in critically ill patients requires precision and accuracy to avoid the delet…