Physical activity as a determinant of total energy expenditure in critically ill children

Martijn van der Kuip, Kees de Meer, Klaas R Westerterp, Reinoud J Gemke

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND & AIMS: For adequate nutritional support of critically ill children, knowledge of the patient's energy expenditure is required. Steady state measurement by a metabolic monitor are defined as resting energy expenditure and may underestimate total energy expenditure in clinical practise. The aim of this study was to investigate total energy expenditure, resting energy expenditure and the relation with physical activity during critical illness and initial recovery.

METHODS: We enrolled 20 patients (0-16 yr) with sepsis or following surgery. During the first week following admission, total energy expenditure was measured with doubly labelled water, and compared with daily resting energy expenditure measurements (metabolic monitor). Activity levels were independently determined by tri-axial accelerometry.

RESULTS: Resting energy expenditure was not different from Schofield's predicted basal metabolic rate, but was 20% lower than total energy expenditure (P=0.006). Overall physical activity level (=total energy expenditure divided by resting energy expenditure) was 1.22 (95%CI: 1.08-1.36) and activity related energy expenditure (=total energy expenditure minus resting energy expenditure) was associated with accelerometry recordings (R(2)=0.72, P=0.02).

CONCLUSIONS: During the week following pediatric intensive care admission, in the individual critically ill patient, activity related energy expenditure should be taken into account to prevent a negative energy balance.

Original languageEnglish
Pages (from-to)744-51
Number of pages8
JournalClinical Nutrition
Volume26
Issue number6
DOIs
Publication statusPublished - Dec 2007

Cite this

@article{e65747be30874d81b82e6b23aad771b4,
title = "Physical activity as a determinant of total energy expenditure in critically ill children",
abstract = "BACKGROUND & AIMS: For adequate nutritional support of critically ill children, knowledge of the patient's energy expenditure is required. Steady state measurement by a metabolic monitor are defined as resting energy expenditure and may underestimate total energy expenditure in clinical practise. The aim of this study was to investigate total energy expenditure, resting energy expenditure and the relation with physical activity during critical illness and initial recovery.METHODS: We enrolled 20 patients (0-16 yr) with sepsis or following surgery. During the first week following admission, total energy expenditure was measured with doubly labelled water, and compared with daily resting energy expenditure measurements (metabolic monitor). Activity levels were independently determined by tri-axial accelerometry.RESULTS: Resting energy expenditure was not different from Schofield's predicted basal metabolic rate, but was 20{\%} lower than total energy expenditure (P=0.006). Overall physical activity level (=total energy expenditure divided by resting energy expenditure) was 1.22 (95{\%}CI: 1.08-1.36) and activity related energy expenditure (=total energy expenditure minus resting energy expenditure) was associated with accelerometry recordings (R(2)=0.72, P=0.02).CONCLUSIONS: During the week following pediatric intensive care admission, in the individual critically ill patient, activity related energy expenditure should be taken into account to prevent a negative energy balance.",
keywords = "Adolescent, Basal Metabolism/physiology, Body Mass Index, Calorimetry, Indirect, Child, Child, Preschool, Critical Illness/mortality, Energy Metabolism/physiology, Exercise/physiology, Female, Humans, Infant, Infant, Newborn, Intensive Care Units, Pediatric/statistics & numerical data, Male, Nutrition Assessment, Nutritional Requirements, Nutritional Support, Oxygen Consumption, Postoperative Care/methods, Respiration, Artificial, Sepsis/metabolism",
author = "{van der Kuip}, Martijn and {de Meer}, Kees and Westerterp, {Klaas R} and Gemke, {Reinoud J}",
year = "2007",
month = "12",
doi = "10.1016/j.clnu.2007.08.005",
language = "English",
volume = "26",
pages = "744--51",
journal = "Clinical Nutrition",
issn = "0261-5614",
publisher = "Churchill Livingstone",
number = "6",

}

Physical activity as a determinant of total energy expenditure in critically ill children. / van der Kuip, Martijn; de Meer, Kees; Westerterp, Klaas R; Gemke, Reinoud J.

In: Clinical Nutrition, Vol. 26, No. 6, 12.2007, p. 744-51.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Physical activity as a determinant of total energy expenditure in critically ill children

AU - van der Kuip, Martijn

AU - de Meer, Kees

AU - Westerterp, Klaas R

AU - Gemke, Reinoud J

PY - 2007/12

Y1 - 2007/12

N2 - BACKGROUND & AIMS: For adequate nutritional support of critically ill children, knowledge of the patient's energy expenditure is required. Steady state measurement by a metabolic monitor are defined as resting energy expenditure and may underestimate total energy expenditure in clinical practise. The aim of this study was to investigate total energy expenditure, resting energy expenditure and the relation with physical activity during critical illness and initial recovery.METHODS: We enrolled 20 patients (0-16 yr) with sepsis or following surgery. During the first week following admission, total energy expenditure was measured with doubly labelled water, and compared with daily resting energy expenditure measurements (metabolic monitor). Activity levels were independently determined by tri-axial accelerometry.RESULTS: Resting energy expenditure was not different from Schofield's predicted basal metabolic rate, but was 20% lower than total energy expenditure (P=0.006). Overall physical activity level (=total energy expenditure divided by resting energy expenditure) was 1.22 (95%CI: 1.08-1.36) and activity related energy expenditure (=total energy expenditure minus resting energy expenditure) was associated with accelerometry recordings (R(2)=0.72, P=0.02).CONCLUSIONS: During the week following pediatric intensive care admission, in the individual critically ill patient, activity related energy expenditure should be taken into account to prevent a negative energy balance.

AB - BACKGROUND & AIMS: For adequate nutritional support of critically ill children, knowledge of the patient's energy expenditure is required. Steady state measurement by a metabolic monitor are defined as resting energy expenditure and may underestimate total energy expenditure in clinical practise. The aim of this study was to investigate total energy expenditure, resting energy expenditure and the relation with physical activity during critical illness and initial recovery.METHODS: We enrolled 20 patients (0-16 yr) with sepsis or following surgery. During the first week following admission, total energy expenditure was measured with doubly labelled water, and compared with daily resting energy expenditure measurements (metabolic monitor). Activity levels were independently determined by tri-axial accelerometry.RESULTS: Resting energy expenditure was not different from Schofield's predicted basal metabolic rate, but was 20% lower than total energy expenditure (P=0.006). Overall physical activity level (=total energy expenditure divided by resting energy expenditure) was 1.22 (95%CI: 1.08-1.36) and activity related energy expenditure (=total energy expenditure minus resting energy expenditure) was associated with accelerometry recordings (R(2)=0.72, P=0.02).CONCLUSIONS: During the week following pediatric intensive care admission, in the individual critically ill patient, activity related energy expenditure should be taken into account to prevent a negative energy balance.

KW - Adolescent

KW - Basal Metabolism/physiology

KW - Body Mass Index

KW - Calorimetry, Indirect

KW - Child

KW - Child, Preschool

KW - Critical Illness/mortality

KW - Energy Metabolism/physiology

KW - Exercise/physiology

KW - Female

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Intensive Care Units, Pediatric/statistics & numerical data

KW - Male

KW - Nutrition Assessment

KW - Nutritional Requirements

KW - Nutritional Support

KW - Oxygen Consumption

KW - Postoperative Care/methods

KW - Respiration, Artificial

KW - Sepsis/metabolism

U2 - 10.1016/j.clnu.2007.08.005

DO - 10.1016/j.clnu.2007.08.005

M3 - Article

VL - 26

SP - 744

EP - 751

JO - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

IS - 6

ER -