The measurement of gas exchange for use in indirect calorimetry is a clinical research tool struggling to find its proper place in the care of acutely ill and nutritionally depleted patients. Some investigators have proposed that it should be used as part of the nutritional assessment. Unfortunately, in common with many other measurements for nutritional assessment, the information provided must be integrated with other information. It is recognized that factors other than malnutrition may influence the level of the metabolic rate. Despite the lack of precision and specificity, the measurement of energy expenditure provides an important reference for determining patients' requirements for energy intake. As with many other procedures in clinical medicine, the more severely ill the patient, the less the accuracy of standard formulas for estimating energy expenditure. Thus, actual measurements of energy expenditure assume special value. (Journal of Parenteral and Enteral Nutrition11:90S-94S, 1987)
Get full access to this article
View all access options for this article.
References
1.
Mullen JL, Buzby GP, Waldman MT, et al: Prediction of operative morbidity and mortality by preoperative nutritional assessment. Surg Forum30:80-82, 1979
2.
Linn BS: A protein energy malnutrition scale (PEMS). Ann Surg200:747-752, 1984
3.
Detsky AS, Baker JP, Mendelson RA, et al: Evaluating the accuracy of nutritional assessment techniques applied to hospitalized patients: Methodology and comparisons. JPEN8:153-159, 1984
4.
Mendelshon E.: Heat and Life: The Development of the Theory of Animal Heat. Harvard University Press, Cambridge, MA , 1964
5.
DuBois EF: Basal Metabolism in Health and Disease. Lea & Febiger , Philadelphia, 1924
6.
Lusk G.: The elements of the Science of Nutrition. W.B. Saunders , Philadelphia, 1931
7.
Weir JB de V.: New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol (Lond)109:1-9, 1949
8.
Consolazio CF, Johnson RE, Pecora LJ: Physiological Measurements of Metabolic Functions in Man. McGraw-Hill, New York, 1963
9.
Georg J., Mellemgaard K.: Sources of error in the determination of metabolic rate. Scand J Clin Lab Invest13:180, 1961
10.
Johnson RE: Techniques for measuring gas exchange. IN Assessment of Energy Metabolism in Health and Disease. Kinney JM (ed). Ross Laboratories, Columbus, OH, 1980, p 32
11.
Kinney JM: The application of indirect calorimetry to clinical studies. IN Assessment of Energy Metabolism in Health and Disease. Report of the First Ross Conference on Medical Research , Kinney JM (ed). Ross Laboratories , Columbus, OH, 1980, p 42
12.
Simopoulos AP, Van Itallie IB: Body weight, health and longevity . Ann Intern Med100:285-295, 1984
13.
Benedict FG : Carnegie Institute, Washington Publ No. 77, 1907
14.
Morgulis: Fasting and Undernutrition . E.P. Dutton & Company, New York, 1923
15.
Benedict FG : A study of prolonged fasting. Carnegie Institute, Washington Publ No. 203, 1915
16.
Keys A., Brozek J., Henschel A., et al: The Biology of Human Starvation. The University of Minnesota Press, Minneapolis, 1950
17.
Kleiber M.: The Fire of Life: An Introduction to Animal Energetics. Robert E. Kreiger Company, Huntington, NY, 1975
18.
Harris JA, Benedict FG: A Biometric Study of Basal Metabolism in Man. Carnegie Institute of Washington, Washington, D.C. , 1919
19.
Boothby WM, Sandiford RB: Nomographic charts for the calculation of the metabolic rate by the gasometer method. Boston Med Surg J185:337, 1921
20.
Fleisch A.: Le metabolisme basal standard et sa determination au moyen du "Metabocalculator."Helv Med Acta18:23-44, 1951
21.
Robertson JE , Reid DD: Standards for the BMR of normal people in Britain. Lancet1:940, 1952
22.
Grande F., Keys A.: Body weight, body composition and calorie status. IN Modern Nutrition in Health and Disease, 6th ed, Goodhart RS, Shils ME (eds). Lea & Febiger, Philadelphia , 1980
23.
Shizgal HM: Nutritional failure. IN Care of the Critically Ill Patient , Tinker J, Rapin M (eds). Springer-Verlag, Berlin , 1983, p 483
24.
Moore FD, Olesen KH, McMurrey JD, et al: The Body Cell Mass and Its Supporting Environment: Body Composition in Health and Disease. W.B. Saunders, 1963
25.
Roza AM, Shizgal HM: The Harris Benedict equation reevaluated: Resting energy requirements and the body cell mass. Am J Clin Nutr40:168-182, 1984
26.
Hill GL, McCarthy ID, Collins JP, et al: A new method for the rapid measurement of body composition in critically ill surgical patients. Br J Surg65:732-735, 1978
27.
McNeill KG, Phil D., Mernagh, et al: In vivo measurements of body protein based on the determination of nitrogen by prompt analysis. Am J Clin Nutr32:1955-1961, 1979
28.
Cohn SH, Vartsky D., Yasumura S., et al: Indexes of body cell mass: Nitrogen versus potassium. Am J Physiol244:E305-E310, 1983
29.
Becker DV: Metabolic indices. IN The Thyroid, 3rd ed, Werner SC, Ingbar SH (eds). Harper & Row , New York, 1955
30.
Kinne JM, Askanazi J., Gump FE, et al: Use of the ventilatory equivalent to separate hypermetabolism from increased dead space ventilation in the injured or septic patient. J Trauma20:111-119, 1980
31.
Roe CF, Kinney JM: The caloric equivalent of fever. II. Influence of major trauma. Ann Surg161:140-147, 1965
32.
Askanazi J. , Carpentier YA, Elwyn DH, et al: Influence of total parenteral nutrition on fuel utilization in injury and sepsis. Ann Surg191:40-46, 1980
33.
Mann S., Westenskow DR, Houtchens BA: Measured and predicted caloric expenditure in the acutely ill. Crit Care Med13:173-177, 1985
34.
Knox LS, Crosby LO, Feurer ID, et al: Energy expenditure in malnourished cancer patients. Ann Surg197:152-162, 1983
35.
McCamish MA , Dean RE, Ouellette TR: Assessing energy requirements of patients on respirators. JPEN5:513-516, 1981
36.
Caldwell FT: Measurement of oxygen consumption and CO2 production in clinical nutritional assessment. IN Nutritional Assessment: Present Status, Future Directions and Prospects, Levenson SM (ed). Ross Laboratories, Columbus, OH, 1981, p 19
37.
Bartlett RH , Dechert RE, Mault JR, et al: Measurement of metabolism in multiple organ failure. Surgery92:771-779, 1982
