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Journal of Parenteral and Enteral Nutrition
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A Single, Accurate Measurement of Resting Metabolic Expenditure

Maurice A. Stokes, M.B., F.R.C.S.I.

Uniuersity Department of Surgery, Auckland Hospital, Auckland, New Zealand

Graham L. Hill, M.D., F.R.A.C.S.

Uniuersity Department of Surgery, Auckland Hospital, Auckland, New Zealand

Indirect calorimetry is widely used in estimating nutritional requirements for severely ill patients. However, because the accuracy of a single measurement is dependent on many factors, the authors have sought to find the optimal single measurement. It is shown here that a more accurate resting metabolic expenditure (RME) can be obtained by studying a fasted, rested patient in relaxing surroundings after acclimatizing him or her to the calorimetric hood. Using this altered protocol, a significantly lower RME (by a mean of 125 kcal/d, p < 0.0001) is achieved. This RME compares well with most of the various predictive equations. A predictive equation, based on the normal patients in this study and relating the RME to TBK (a measure of the body cell mass), allows calculation of a predicted RME, and subsequently a Stress Index as a measure of metabolic stress, ie, Predicted RME = TBK x 0.34 + 4.94. Stress Index = Measured RME/Predicted RME (Journal of Parenteral and Enteral Nutrition 15:281-287, 1991)

Journal of Parenteral and Enteral Nutrition, Vol. 15, No. 3, 281-287 (1991)
DOI: 10.1177/0148607191015003281
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