Energy Estimation in the Critically Ill: A Literature Review

摘要

Critically ill patients have higher energy expenditure and increased nutritional needs compared to non-critically patients. This can lead to medical malnutrition if nutritional interventions are not implemented quickly and accurately in the disease course. Obtaining an accurate estimation of nutritional needs is paramount in establishing nutritional support. The literature review was designed to look at the numerous predictive equations and determine the accuracy among different critically ill patient populations. Data Sources: Using keywords energy estimation, nutritional predictive equations, and critical illness, systematic reviews, meta-analyses, and validation studies were identified through electronic database searches and citation tracking. Study Selection: Articles were selected that evaluated individual predictive equations in critically ill patients, their accuracy compared to indirect calorimetry, and their use in special patient populations. Data Extraction and Synthesis: A total of 12 articles were selected using the inclusion and exclusion criteria. Accuracy of the predictive equations was separated into overall accuracy among all patients, all ages, non-obese, young obese and non-obese, and elderly obese and non-obese. Conclusions: There are several validated predictive equations for estimating energy expenditure in critical illness. The most accurate equations are the 2003 Penn State equation, for obese and non-obese adult patients, and the 2010 Penn State equation, for elderly obese patients. Given the trend of obesity in the United States, further validated studies are needed to look at the individual classes of obesity and the accuracy with this specific patient population.