Abstract from the 25th Clinical Congress of the American Society for Parenteral and Enteral Nutrition, Chicago, IL, January 21-24, 2001

Brown, Rex O.

Dickerson, Roland N.

Gervasio, Jane M.

Hickerson, William L.

Kudsk, Kenneth A.

Murrell, James E.

Riley, Marti L.

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Butler UniversityDigital Commons @ Butler UniversityScholarship and Professional Work – COPHS College of Pharmacy & Health Sciences1-2001Accuracy of predictive formulas to estimate restingenergy expenditure of thermally injured patientsRoland N. DickersonJane M. GervasioButler University, jgervasi@butler.eduMarti L. RileyJames E. MurrellWilliam L. HickersonSee next page for additional authorsFollow this and additional works at: http://digitalcommons.butler.edu/cophs_papersPart of the Pharmacy and Pharmaceutical Sciences CommonsThis Article is brought to you for free and open access by the College of Pharmacy & Health Sciences at Digital Commons @ Butler University. It hasbeen accepted for inclusion in Scholarship and Professional Work – COPHS by an authorized administrator of Digital Commons @ Butler University.For more information, please contact fgaede@butler.edu.Recommended CitationDickerson, Roland N.; Gervasio, Jane M.; Riley, Marti L.; Murrell, James E.; Hickerson, William L.; Kudsk, Kenneth A.; and Brown,Rex O., "Accuracy of predictive formulas to estimate resting energy expenditure of thermally injured patients" (2001). Scholarship andProfessional Work – COPHS. Paper 26.http://digitalcommons.butler.edu/cophs_papers/26AuthorsRoland N. Dickerson, Jane M. Gervasio, Marti L. Riley, James E. Murrell, William L. Hickerson, Kenneth A.Kudsk, and Rex O. BrownThis article is available at Digital Commons @ Butler University: http://digitalcommons.butler.edu/cophs_papers/26Accuracy of predictive formulas to estimate resting energy expenditure of thermally injured patients !Roland N. Dickerson, Jane M. Gervasio, Marti L. Riley, James E. Murrell, William L. Hickerson, Kenneth A. Kudsk, Rex O. Brown !!The purpose of this study was to evaluate the bias and precision of 27 published methods for estimating resting energy expenditure (REE) of thermally injured patients. Twenty four adult patients (≥ 20% TBSA burn) admitted to the burn center who required specialized nutrition support and who had their REE measured via indirect calorimetry (IC) were evaluated. Patients with morbid obesity (weight ≥ 150% IBW) or those requiring an FiO2 > 50% or PEEP ≥ 10 cmH2O were excluded. One steady state, resting IC measurement (MEE) was obtained per patient. The statistical methods of Sheiner and Beal were used to assess bias and precision of these equations. The formulas were considered unbiased if the 95% confidence interval (CI) for the error (kcals/d) intersected zero and were considered precise if the CI for the absolute error (%) was within 15% of MEE. Data are given as mean ± SD. !N (M/F) 24 (19/5); Age (yrs) 36 ± 12; Weight (kg) 82 ± 21; TBSA (%) 37 ± 15; Burn Severity Index 7.3 ± 2.0; Post-Burn Day 7.7 ± 4.8; MEE (kcals/d) 2780 ± 567; REE (% of BEE) 160 ± 28. !Six methods were biased toward under-predicting MEE, 11 were over-predictive, and 10 were unbiased. None of the formulas were precise. It is recommended that patients with thermal injury be measured by IC to evaluate caloric expenditure. If IC measurements cannot be obtained, the most accurate unbiased methods for estimating resting energy expenditure are 1.5 X Harris-Benedict equations, Cunningham, and Saffle equations. "1!Table 1. Selected methods commonly used in clinical practice      Bias (Kcals/day)   Absolute error      (95% CI)   (mean ± SD, 95% CI) Modified Curreri (50% burn)  309 to 959   32 ± 34, 19 to 45 Toronto formula    -869 to -280   26 ± 21, 17 to 34 35 kcal/kg/day    -262 to 439   23 ± 35, 9 to 37 1.5 X Harris-Benedict eqs.   -369 to 186   19 ± 24, 10 to 29 Cunningham, 1989   -420 to 74   18 ± 19, 10 to 25 Saffle, 1988    -317 to  391   20 ± 21, 12 to 28"2

Accuracy of predictive formulas to estimate resting energy expenditure of thermally injured patients

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Accuracy of predictive formulas to estimate resting energy expenditure of thermally injured patients

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