Calorimetry for enteral feeding in critically ill patients

Abstract

The nutritional assessment is important in a critically ill patient to improve the outcome. In clinical practice, the patients’ energy needs may be assessed by predictive equations or measured by indirect calorimetry. Predictive equations do not provide true values because of various confounders and interindividual variation and thus requires its cautious use. Indirect calorimetry has emerged as a gold standard assessment tool and can easily be performed in a critical care setup. Optimal nutrition intervention requires continuous evaluation of all pertinent clinical data and monitoring of each patient’s response to metabolic stress and therapeutic nutrition interventions. A thorough understanding of the variables associated with indirect calorimetry measurements and what circumstances can confound results can help optimize patient care and minimize confusing or erroneous interpretation. Clinical judgment should be used to individualize each patient’s estimated caloric needs. The frequent monitoring and evaluation of nutrition interventions should occur to make adjustments as needed based on patient response. This chapter focuses on the useful role of indirect calorimetry in critically ill patients for nutrition optimization.