This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Ogawa, A. M. Articles by Muskat, P. C. Search for Related Content PubMed PubMed Citation Articles by Ogawa, A. M. Articles by Muskat, P. C. Social Bookmarking                         What's this?

The Thermodilution Technique for Measuring Resting Energy Expenditure Does Not Agree With Indirect Calorimetry for the Critically III Patient

Nutritional Medicine Division, Wilford Hall Medical Center, Lackland Air Force Base, Texas

Scott A. Shikora, MD, FACS

Department of Surgery, Wilford Hall Medical Center, Lackland Air Force Base, Texas, Department of Surgery, Faulkner Hospital, Tufts University School of Medicine, Boston, MA

Linda M. Burke, BS, RD, CNSD

Nutritional Medicine Division, Wilford Hall Medical Center, Lackland Air Force Base, Texas

Jane E. Heetderks-Cox, BS, RD, CNSD

Nutritional Medicine Division, Wilford Hall Medical Center, Lackland Air Force Base, Texas

Carl T. Bergren, MD, FACST

Department of Surgery, Wilford Hall Medical Center, Lackland Air Force Base, Texas, Department of Surgery, Oakwood Hospital and Medical Center, Dearborn, MI

Peter C. Muskat, MD, FACS

Department of Surgery, Wilford Hall Medical Center, Lackland Air Force Base, Texas

Background: The complications associated with overfeeding critically ill patients are well documented. Indirect calorimetry is touted as the gold standard for measuring resting energy expenditure (REE). Unfortunately, the device is expensive, and many centers do not have this technology. The thermodilution technique for measuring cardiac output and calculating REE using the Fick equation has been reported to be an acceptable alternative. This study compared these techniques in a critically ill population. Methods: Forty consecutive patients with indwelling Swan—Ganz catheters in the surgical intensive care unit were prospectively studied while under the consultative care of the nutrition support service. REE was determined in all patients by both techniques within a 2-hour period. An error of 5% (approximately ±100 kcal/d) between the two methods was deemed acceptable for clinical use. Results: Mean values for REE were 1928 ± 558 vs 1898 ± 518 kcal/d for the indirect calorimetry and thermodilution methods, respectively, and were not significantly different. However, there was great variation between the two techniques for the majority of patients such that REE determinations did not agree (t = 6.8; p < .0005). In 70% of the patients, REE determinations differed by 20% and in 10% of the patients by 50%. Additionally, the greater the difference between the two methods, the more the thermodilution method tended to overestimate REE. Conclusions: When compared with indirect calorimetry in a critically ill population, the thermodilution method demonstrated an intersubject variability that is unacceptable for clinical use. (Journal of Parenteral and Enteral Nutrition 22:347-351, 1998)

Journal of Parenteral and Enteral Nutrition, Vol. 22, No. 6, 347-351 (1998)
DOI: 10.1177/0148607198022006347


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				K. E. Holdy Monitoring Energy Metabolism with Indirect Calorimetry: Instruments, Interpretation, and Clinical Application Nutr Clin Pract, October 1, 2004; 19(5): 447 - 454. [Abstract] [Full Text] [PDF]

				C. Faisy, E. Guerot, J.-L. Diehl, J. Labrousse, and J.-Y. Fagon Assessment of resting energy expenditure in mechanically ventilated patients Am. J. Clinical Nutrition, August 1, 2003; 78(2): 241 - 249. [Abstract] [Full Text] [PDF]