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Determination of the Resting Energy Expenditure in
Hospitalized / Critically ill Patients
Select all that apply
Equations are listed below. The final selection of equations was based on information found within the ADA evidence library and the following reference:
Walker RN, Heuberger RA. Predictive Equations for Energy Needs for the Critically Ill. Respir Care 2009;54(4):509 –521.
Direct quotes: "Understanding an equation’s reference population and using the equation with similar patients are essential for the equation to perform similarly. Prediction accuracy among equations is rarely within 10% of the measured energy expenditure; however, in the absence of indirect calorimetry, a prediction equation is the best alternative." "However, if an equation must be used, the 1998 and 2003 Penn State equations, the 1992 Ireton-Jones equation, and the Swinamer equation are worthy of consideration."
: during the next update, additional equations may be added. This initial version will only calculate results for the Ireton-Jones equations.
Ireton-Jones Energy Equations IJEE
IJEE(v) = 1784 - 11(A)+ 5(W)+244 (G) + 239(T) + 804(B)
2002 version (revised 1997 equation).
IJEE(v) = 1925 - 10(A) + 5(W) +281 (G) +292 (T) +851 (B)
IJEE(s) = 629 - 11 (A) + 25 (W) - 609 (O)
IJEE = kcal/day; A = age (yrs); W = actual wt(kg); G = gender(male=1, female=0); T = trauma, B = burn, O=obesity( if present=1, absent=0)
No additional factor is added for activity or injury
Ireton-Jones C, Jones JD. Improved equations for predicting energy expenditure in patients: The Ireton-Jones equations. Nutr Clin Pract. 2002;17:29-31.
Ireton-Jones CA, Turner WW, Liepa GU, Baxter CR. Equations for the estimation of energy expenditures in patients with burns with special reference to ventilatory status. J Burn Care Rehabil 1992; 13(3):330-333.
Other equations to consider:
Harris Benedict Equations must be used with a custom stress factor:
BMR calculation for men (metric)
BMR = 66.47 + ( 13.75 x weight in kg ) + ( 5.003 x height in cm ) - ( 6.755 x age in years )
BMR calculation for women (metric)
BMR = 655.1 + ( 9.563 x weight in kg ) + ( 1.850 x height in cm ) - ( 4.676 x age in years )
: Harris JA, Benedict FG. A biometric study of human basal metabolism. Proc Natl Acad Sci USA 1918;4(12):370-3.
Penn State Equations
Penn State 1998 equation
(1.1 x value from Harris-Benedict equation - use ajbw if obese) + (140 x Tmax)+ (32 x VE) - 5340
Penn State 2003 equation
(0.85 x value from Harris-Benedict equation) + (175 x Tmax) + (33 x VE) - 6,433
Frankenfield D, Smith S, Cooney RN. Validation of 2 approaches to predicting resting metabolic rate in critically ill patients. JPEN J Parenter Enteral Nutr 2004;28(4):259-264.
Swinamer 1990 equation
(945 x body surface area) - (6.4 x age) + (108 x temp in celsius) + (24.2 x respiratory rate in breaths/min) + (817 x VT) - 4349
Swinamer DL, Grace MG, Hamilton SM, Jones RL, Roberts P, King G. Predictive equation for assessing energy expenditure in mechanically ventilated critically ill patients. Crit Care Med 1990;18(6):657-661.
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