Comparison of resting energy expenditure prediction equations in obese trauma and burn patients

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Show simple item record Stucky, Chee-Chee 2006-07-05T21:13:52Z 2006-07-05T21:13:52Z 2006-07-05T21:13:52Z
dc.description Clinical Studies II Room G026 Dykes 1:54 PM Abstract 144 en
dc.description.abstract Background: While the prevalence of obesity continues to increase in our society, outdated resting energy expenditure (REE) prediction equations may over-predict energy requirements in obese patients. Therefore, many physicians now advocate the use of the Cunningham equation (CE) based on fat free mass (FFM). Accurate feeding is essential since overfeeding has been demonstrated to adversely affect outcomes. Objectives: The first objective was to compare REE calculated by prediction equations to the measured REE in obese trauma and burn patients. Our hypothesis was an equation using FFM would give a more accurate prediction. The second objective was to consider the effect of a commonly used injury factor on the predicted REE. Methods: A retrospective chart review was performed on 33 patients. REE was measured using indirect calorimetry and compared with the Harris-Benedict Equation (HBE), CE and an equation using type II diabetes as a factor (DE). Statistical analyses used were paired t-test, ±95% confidence interval, and the Bland-Altman method. Results: Measured average REE in trauma and burn patients was 21.37±5.26 and 21.81±3.35 kcal/kg-day, respectively. HBE under-predicted REE in trauma by 11.98±21.28% and in burn by 13.05±21.42%. CE under-predicted REE in trauma by 31.26±26.05% and in burn by 31.15±25.22%. DE under-predicted REE in trauma by 15.25±23.32% and in burn by 16.63±18.84%. Using a standard injury factor of 1.2, CE under-estimated by 9.38±21.71% in trauma and 9.29±21.02% in burn patients. HBE over-estimated by 6.68±17.73% in trauma and 5.79±17.85% in burn patients. DE over-estimated by 3.96±19.43% in trauma and 2.81±15.37% in burn patients. Conclusions: The measured average REE is significantly less than current guidelines of 25-27 kcal/kg-day. This suggests that a hypocaloric regimen may be worth considering for ICU individuals possibly using the CE. Also, if an injury factor of 20% is incorporated in either the HBE or DE, patients may be given too many kilocalories possibly leading to worsening outcomes. en
dc.description.sponsorship Moncure, Michael General Surgey en
dc.format.extent 1560064 bytes
dc.format.mimetype application/
dc.language.iso en_US en
dc.subject resting energy expenditure en
dc.subject trauma and burn en
dc.title Comparison of resting energy expenditure prediction equations in obese trauma and burn patients en
dc.type Presentation en

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