Simple and accurate assessment of energy expenditure in ventilated paediatric intensive care patients

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

AIMS: To assess validity and reliability of energy expenditure measurements with a short Douglas bag protocol compared to the standard metabolic monitor in a paediatric intensive care setting.

METHODS: 51 paired measurements were performed in 14 ventilated patients (age 0-18 years) with sepsis, trauma or following major surgery. Measured data were compared mutually and compared to Schofield equations using Bland-Altman analysis.

RESULTS: Comparing Douglas bag (3.21 +/- 1.43 MJ/day) and metabolic monitor (3.15 +/- 1.49 MJ/day) we found bias in energy expenditure of -0.06 (equal to -2%, NS) with limits of agreement of -0.5 to 0.4 MJ/day (equal to -16% to +13%). Intra-measurement variability (coefficient of variation) was within 10% for both methods. Both the metabolic monitor and Douglas bag showed significant bias compared to Schofield equations (3.39 +/-1.64 MJ/day) of -7% (P < 0.01) and -5% (P < 0.05), respectively, with wide limits of agreement: metabolic monitor vs. Schofield: -37% to +22%, Douglas bag vs. Schofield: -37% to +26%.

CONCLUSIONS: The Douglas bag method compared favourably to the metabolic monitor where Schofield equations failed to predict individual energy expenditure. Considering its low cost, this renders the short and simple Douglas bag method a robust measure and a routinely applicable instrument for tailored nutritional assessment in critically ill children.

Original languageEnglish
Pages (from-to)657-63
Number of pages7
JournalClinical Nutrition
Volume23
Issue number4
DOIs
Publication statusPublished - Aug 2004

Cite this

@article{d1e33d8fe9c540a89ce94aad55d1c6e3,
title = "Simple and accurate assessment of energy expenditure in ventilated paediatric intensive care patients",
abstract = "AIMS: To assess validity and reliability of energy expenditure measurements with a short Douglas bag protocol compared to the standard metabolic monitor in a paediatric intensive care setting.METHODS: 51 paired measurements were performed in 14 ventilated patients (age 0-18 years) with sepsis, trauma or following major surgery. Measured data were compared mutually and compared to Schofield equations using Bland-Altman analysis.RESULTS: Comparing Douglas bag (3.21 +/- 1.43 MJ/day) and metabolic monitor (3.15 +/- 1.49 MJ/day) we found bias in energy expenditure of -0.06 (equal to -2{\%}, NS) with limits of agreement of -0.5 to 0.4 MJ/day (equal to -16{\%} to +13{\%}). Intra-measurement variability (coefficient of variation) was within 10{\%} for both methods. Both the metabolic monitor and Douglas bag showed significant bias compared to Schofield equations (3.39 +/-1.64 MJ/day) of -7{\%} (P < 0.01) and -5{\%} (P < 0.05), respectively, with wide limits of agreement: metabolic monitor vs. Schofield: -37{\%} to +22{\%}, Douglas bag vs. Schofield: -37{\%} to +26{\%}.CONCLUSIONS: The Douglas bag method compared favourably to the metabolic monitor where Schofield equations failed to predict individual energy expenditure. Considering its low cost, this renders the short and simple Douglas bag method a robust measure and a routinely applicable instrument for tailored nutritional assessment in critically ill children.",
keywords = "Adolescent, Algorithms, Calorimetry, Indirect, Child, Child, Preschool, Energy Metabolism/physiology, Female, Humans, Infant, Intensive Care Units, Pediatric, Male, Nutrition Assessment, Nutritional Requirements, Oxygen Consumption/physiology, Predictive Value of Tests, Reproducibility of Results, Respiration, Artificial, Sensitivity and Specificity, Severity of Illness Index",
author = "{van der Kuip}, Martijn and {de Meer}, Kees and Oosterveld, {Michiel J S} and Lafeber, {Harry N} and Gemke, {Reinoud J B J}",
note = "Copyright 2003 Elsevier Ltd.",
year = "2004",
month = "8",
doi = "10.1016/j.clnu.2003.11.001",
language = "English",
volume = "23",
pages = "657--63",
journal = "Clinical Nutrition",
issn = "0261-5614",
publisher = "Churchill Livingstone",
number = "4",

}

Simple and accurate assessment of energy expenditure in ventilated paediatric intensive care patients. / van der Kuip, Martijn; de Meer, Kees; Oosterveld, Michiel J S; Lafeber, Harry N; Gemke, Reinoud J B J.

In: Clinical Nutrition, Vol. 23, No. 4, 08.2004, p. 657-63.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Simple and accurate assessment of energy expenditure in ventilated paediatric intensive care patients

AU - van der Kuip, Martijn

AU - de Meer, Kees

AU - Oosterveld, Michiel J S

AU - Lafeber, Harry N

AU - Gemke, Reinoud J B J

N1 - Copyright 2003 Elsevier Ltd.

PY - 2004/8

Y1 - 2004/8

N2 - AIMS: To assess validity and reliability of energy expenditure measurements with a short Douglas bag protocol compared to the standard metabolic monitor in a paediatric intensive care setting.METHODS: 51 paired measurements were performed in 14 ventilated patients (age 0-18 years) with sepsis, trauma or following major surgery. Measured data were compared mutually and compared to Schofield equations using Bland-Altman analysis.RESULTS: Comparing Douglas bag (3.21 +/- 1.43 MJ/day) and metabolic monitor (3.15 +/- 1.49 MJ/day) we found bias in energy expenditure of -0.06 (equal to -2%, NS) with limits of agreement of -0.5 to 0.4 MJ/day (equal to -16% to +13%). Intra-measurement variability (coefficient of variation) was within 10% for both methods. Both the metabolic monitor and Douglas bag showed significant bias compared to Schofield equations (3.39 +/-1.64 MJ/day) of -7% (P < 0.01) and -5% (P < 0.05), respectively, with wide limits of agreement: metabolic monitor vs. Schofield: -37% to +22%, Douglas bag vs. Schofield: -37% to +26%.CONCLUSIONS: The Douglas bag method compared favourably to the metabolic monitor where Schofield equations failed to predict individual energy expenditure. Considering its low cost, this renders the short and simple Douglas bag method a robust measure and a routinely applicable instrument for tailored nutritional assessment in critically ill children.

AB - AIMS: To assess validity and reliability of energy expenditure measurements with a short Douglas bag protocol compared to the standard metabolic monitor in a paediatric intensive care setting.METHODS: 51 paired measurements were performed in 14 ventilated patients (age 0-18 years) with sepsis, trauma or following major surgery. Measured data were compared mutually and compared to Schofield equations using Bland-Altman analysis.RESULTS: Comparing Douglas bag (3.21 +/- 1.43 MJ/day) and metabolic monitor (3.15 +/- 1.49 MJ/day) we found bias in energy expenditure of -0.06 (equal to -2%, NS) with limits of agreement of -0.5 to 0.4 MJ/day (equal to -16% to +13%). Intra-measurement variability (coefficient of variation) was within 10% for both methods. Both the metabolic monitor and Douglas bag showed significant bias compared to Schofield equations (3.39 +/-1.64 MJ/day) of -7% (P < 0.01) and -5% (P < 0.05), respectively, with wide limits of agreement: metabolic monitor vs. Schofield: -37% to +22%, Douglas bag vs. Schofield: -37% to +26%.CONCLUSIONS: The Douglas bag method compared favourably to the metabolic monitor where Schofield equations failed to predict individual energy expenditure. Considering its low cost, this renders the short and simple Douglas bag method a robust measure and a routinely applicable instrument for tailored nutritional assessment in critically ill children.

KW - Adolescent

KW - Algorithms

KW - Calorimetry, Indirect

KW - Child

KW - Child, Preschool

KW - Energy Metabolism/physiology

KW - Female

KW - Humans

KW - Infant

KW - Intensive Care Units, Pediatric

KW - Male

KW - Nutrition Assessment

KW - Nutritional Requirements

KW - Oxygen Consumption/physiology

KW - Predictive Value of Tests

KW - Reproducibility of Results

KW - Respiration, Artificial

KW - Sensitivity and Specificity

KW - Severity of Illness Index

U2 - 10.1016/j.clnu.2003.11.001

DO - 10.1016/j.clnu.2003.11.001

M3 - Article

VL - 23

SP - 657

EP - 663

JO - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

IS - 4

ER -