Dc. Frankenfield et al., VALIDATION OF A 5-MINUTE STEADY-STATE INDIRECT CALORIMETRY PROTOCOL FOR RESTING ENERGY-EXPENDITURE IN CRITICALLY ILL PATIENTS, Journal of the American College of Nutrition, 15(4), 1996, pp. 397-402
Objective: Numerous protocols are used for indirect calorimetry in res
earch and clinical settings. The objective of the current study was to
validate in critically ill patients an abbreviated protocol that uses
five consecutive stable 1-minute readings of oxygen consumption (VO2)
, carbon dioxide production (VCO2), and minute ventilation (V-E) in a
range of +/- 5%, versus a more standard protocol that uses 30 consecut
ive stable one minute readings of VO2, VCO2, and V-E in a range of +/-
10%. Methods: Indirect calorimetry was performed on resting, mechanic
ally ventilated, critically ill patients. The first 5-minute period in
which coefficients of variation for VO2, VCO2 and V-E were less than
or equal to 5% was compared to the first 30-minute period in which coe
fficients of variation for these variables were less than or equal to
10%. Results: Thirty-four critically ill patients were studied. Twenty
four patients (70%) successfully completed both protocols (Success Gr
oup). Eighteen percent of subjects completed neither the abbreviated n
or the 30 minute protocol, and 12% completed only one protocol (Fail G
roup). The Success Group was marked by a higher incidence of sedation
and/or medical paralysis. There were no significant differences in V-E
, VO2, VCO2, respiratory quotient, or energy expenditure between the p
rotocols in the Success Group or the Fail Group. Coefficients of deter
mination (R(2)) for VO2 and VCO2 between the two methods in the Succes
s Group were 0.99. In the Fail Group, R(2) values ranged from 0.75 for
VCO2 to 0.91 for VO2. Conclusion: In sedated, mechanically ventilated
patients, an indirect calorimetry test of five consecutive 1-minute p
eriods with coefficient of variation less than or equal to 5% is equiv
alent to a longer test consisting of 30 consecutive 1-minute periods w
ith coefficient of variation less than or equal to 10%.