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Open Access 01-12-2016 | Research

Measuring energy expenditure in the intensive care unit: a comparison of indirect calorimetry by E-sCOVX and Quark RMR with Deltatrac II in mechanically ventilated critically ill patients

Authors: Martin Sundström Rehal, Erik Fiskaare, Inga Tjäder, Åke Norberg, Olav Rooyackers, Jan Wernerman

Published in: Critical Care | Issue 1/2016

Abstract

Background

Indirect calorimetry allows the determination of energy expenditure in critically ill patients by measuring oxygen consumption (VO₂) and carbon dioxide production (VCO₂). Recent studies have demonstrated variable performance of “breath-by-breath” instruments compared to mixing chamber technology. The aim of this study was to validate two modern devices (E-sCOVX and Quark RMR) against a reference method (Deltatrac II).

Method

Measurements of VO₂/VCO₂ with the test and reference devices were performed simultaneously over a 20-min period in mechanically ventilated adult intensive care unit patients. Accuracy and precision of instruments were analyzed using Bland-Altman plots.

Results

Forty-eight measurements in 22 patients were included for analysis. Both E-sCOVX and Quark RMR overestimated VO₂ and VCO₂ compared to Deltatrac II, corresponding to a 10 % higher mean resting energy expenditure. Limits of agreement of resting energy expenditure within ±2 standard deviations were ±461 kcal/24 h (±21 % expressed as percentage error) for ΔE-sCOVX–Deltatrac II and ±465 kcal/24 h (±22 %) for ΔQuark RMR–Deltatrac II.

Conclusion

Both test devices overestimate VO₂ and VCO₂ compared to Deltatrac II. The observed limits of agreement are comparable to those commonly accepted in evaluations of circulatory monitoring, and significantly less than results from predictive equations. We hypothesize that the discrepancy between methods is due to patient/ventilator-related factors that affect the synchronization of gas and spirometry waveforms.

Trial registration

Australian New Zealand Clinical Trials Registry, Trial ID ACTRN12615000205538. Date registered 3 March 2015.

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Title: Measuring energy expenditure in the intensive care unit: a comparison of indirect calorimetry by E-sCOVX and Quark RMR with Deltatrac II in mechanically ventilated critically ill patients
Authors: Martin Sundström Rehal
Erik Fiskaare
Inga Tjäder
Åke Norberg
Olav Rooyackers
Jan Wernerman
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2016
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-016-1232-6

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Measuring energy expenditure in the intensive care unit: a comparison of indirect calorimetry by E-sCOVX and Quark RMR with Deltatrac II in mechanically ventilated critically ill patients

Abstract

Background

Method

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Method

Results

Conclusion

Trial registration

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