China
Africa
Explore chapters and articles related to this topic
Parenteral and Enteral Nutrition in Critical Illness
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
For this reason, some have suggested utilizing the adjusted body weight (ABW) instead of IBW for nutritional calculations in Harris–Benedict equation (HBE) and other prediction models (Anderegg et al. 2009). However, this approach is not universally accepted. It is preferable to obtain an indirect calorimetry measured REE whenever possible in the obese critically ill.
Nutrition Screening and ADIME
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Jennifer L. Smith, Teresa A. Capello
Indirect calorimetry is considered the gold standard for establishing energy goals for the critically ill patient. Indirect calorimetry is the determination of heat production of a biochemical reaction by measuring uptake of oxygen and release of carbon dioxide. Oxygen consumption (VO2) and carbon dioxide production (VCO2) measured by the calorimeter are entered into the Weir equation to calculate resting energy expenditure (REE):
Nutrition
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
In 1900, Atwater and Rosa developed a human calorimeter to directly measure the total heat output of a human. This consisted of a chamber where a person would live and work for several days, and at the same time, the net energy intake could be related to the total output of heat. However, direct calorimetry is difficult to measure, and as heat output is quantitatively related to oxygen utilization, the measurement of O2 consumption is normally used in indirect calorimetry. This is based on the assumption that 1 L of O2 used is equivalent to the production of 4.8 kcal of energy.
Nutrition support in critical care: How does a South African unit measure up against the suggested guidelines and against the world?
Published in South African Journal of Clinical Nutrition, 2023
Both the European Society for Clinical Nutrition and Metabolism (ESPEN) and the American Society of Parenteral and Enteral Nutrition (ASPEN) in their published guidelines agreed that indirect calorimetry (IC) should be used to determine energy requirements in the critically ill patients, where feasible and available.1, 3 However, ESPEN advocated a progressive implementation of energy provision.3 In this approach, hypocaloric nutrition not exceeding 70% of energy expenditure, in the early phase of acute illness was recommended.3 Provision of 80–100% of requirements should only be implemented after 72 hours following admission.3 In the absence of IC, ASPEN and ESPEN suggest that simple weight-based equations be used.1, 3 The ASPEN 2016 guidelines gave a range of 25–30 kCal/kg/day.1 ESPEN however suggested that hypocaloric nutrition support, below 70% of estimated needs, should be continued for the first week of ICU stay when weight-based equations are being used.3 The reasoning behind progressively increasing energy provision in the critical care setting by ESPEN is based on earlier data (Tappy et al. 1998), which showed that exogenous glucose provision does not suppress endogenous glucose production.4 Endogenous energy production, which occurs in the early phase of critical illness, can provide 500–1 400 kCal/day.3, 4 Currently, it is not possible to measure this endogenous production at the point-of-care, however providing full measured or calculated requirements during this stage would result in overfeeding.3, 4
Resting energy expenditure in Parkinson’s disease patients under dopaminergic treatment
Published in Nutritional Neuroscience, 2022
Michela Barichella, Emanuele Cereda, Samanta Andrea Faierman, Gabriele Piuri, Carlotta Bolliri, Valentina Ferri, Erica Cassani, Eleonora Vaccarella, Ornella Violetta Donnarumma, Giovanna Pinelli, Serena Caronni, Chiara Pusani, Gianni Pezzoli
PD patients – mainly those suffering from obesity and/or more severe disease – may be characterized by an increase in REE due to different potential mechanisms associated with disease progression (e.g. hyperkinetic motor symptoms or increased rigidity). Resting energy expenditure equations for healthy people appear to be inaccurate, particularly in patients presenting a H&Y stage ≥3. Among the tested equations, those regressed by Mifflin St. Jeor were found to be the most accurate, particularly in overweight patients. The newly constructed predictive equation provided better estimations of REE but important limitations remain for patients with a H&Y stage ≥3. Its introduction in clinical practice can be proposed to address the issue of indirect calorimetry unavailability. However, in all the cases in which nutritional status is difficult to maintain, the recommendation is to measure REE and to proceed with a more in-depth evaluation of all major factors contributing to energy homeostasis.
A Randomized, Double-Blind, Crossover Study to Determine the Available Energy from Soluble Fiber
Published in Journal of the American College of Nutrition, 2021
Kirstie Canene-Adams, Lisa Spence, Lore W. Kolberg, Kavita Karnik, DeAnn Liska, Eunice Mah
Non-digestible carbohydrates are fermented to varying degrees by intestinal microbes and metabolized into short chain fatty acids (SCFA), gasses (e.g., carbon dioxide, hydrogen, methane), and bacterial cell components. SCFA are absorbed from the large intestine and provide energy to the host (1). Thus, the amount of available energy from non-digestible and fermentable carbohydrates is dependent upon the amount of SCFA produced. The energy values for fermentable fibers are important for reformulation and nutrition labeling purposes. The available energy from fibers in humans may be estimated using indirect calorimetry (2) or breath hydrogen excretion (3–6). Indirect calorimetry studies are time-consuming, expensive, and stressful for subjects and thus, are not commonly done. In contrast, breath hydrogen excretion studies are simple, noninvasive, and have been used for estimating the available energy of various non-digestible carbohydrates (3–6).