1 Nutritional Therapy Multidisciplinary Team, Hospital Copa D'Or, Rua Figueiredo de Magalhães, Rio de Janeiro, Brazil.
2 Institute of Nutrition, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, Rio de Janeiro, Brazil.
JPEN J Parenter Enteral Nutr. 2017 Jul;41(5):776-784. doi: 10.1177/0148607115625609. Epub 2016 Jan 29.
Predictive equations (PEs) are used for estimating resting energy expenditure (REE) when the measurements obtained from indirect calorimetry (IC) are not available. This study evaluated the degree of agreement and the accuracy between the REE measured by IC (REE-IC) and REE estimated by PE (REE-PE) in mechanically ventilated elderly patients admitted to the intensive care unit (ICU).
REE-IC of 97 critically ill elderly patients was compared with REE-PE by 6 PEs: Harris and Benedict (HB) multiplied by the correction factor of 1.2; European Society for Clinical Nutrition and Metabolism (ESPEN) using the minimum (ESPENmi), average (ESPENme), and maximum (ESPENma) values; Mifflin-St Jeor; Ireton-Jones (IJ); Fredrix; and Lührmann. Degree of agreement between REE-PE and REE-IC was analyzed by the interclass correlation coefficient and the Bland-Altman test. The accuracy was calculated by the percentage of male and/or female patients whose REE-PE values differ by up to ±10% in relation to REE-IC.
For both sexes, there was no difference for average REE-IC in kcal/kg when the values obtained with REE-PE by corrected HB and ESPENme were compared. A high level of agreement was demonstrated by corrected HB for both sexes, with greater accuracy for women. The best accuracy in the male group was obtained with the IJ equation but with a low level of agreement.
The effectiveness of PEs is limited for estimating REE of critically ill elderly patients. Nonetheless, HB multiplied by a correction factor of 1.2 can be used until a specific PE for this group of patients is developed.
当无法获得间接测热法（IC）获得的测量值时，预测方程（PE）用于估计静息能量消耗（REE）。本研究评估了在入住重症监护病房（ICU）的机械通气老年患者中，IC 测量的 REE（REE-IC）与 PE 估计的 REE（REE-PE）之间的一致性程度和准确性。
比较了 97 名危重老年患者的 REE-IC 与 6 种 PE（HB 乘以 1.2 的校正系数；ESPEN 使用最小（ESPENmi）、平均（ESPENme）和最大（ESPENma）值；Mifflin-St Jeor；Ireton-Jones（IJ）；Fredrix；和 Lührmann）的 REE-PE。通过组内相关系数和 Bland-Altman 检验分析 REE-PE 与 REE-IC 之间的一致性程度。通过 REE-PE 值与 REE-IC 相差最多±10%的男性和/或女性患者的百分比计算准确性。
对于男性和女性，当使用校正后的 HB 和 ESPENme 计算 REE-PE 时，平均 REE-IC 的千卡/公斤没有差异。校正后的 HB 对两性均显示出高度一致性，女性的准确性更高。在男性组中，IJ 方程获得了最佳的准确性，但一致性较低。
PE 估计危重老年患者 REE 的有效性有限。尽管如此，在为该组患者开发特定的 PE 之前，可以使用乘以 1.2 的校正系数的 HB。
