PMID- 33300194 OWN - NLM STAT- MEDLINE DCOM- 20210831 LR - 20210831 IS - 1941-2452 (Electronic) IS - 0884-5336 (Linking) VI - 36 IP - 2 DP - 2021 Apr TI - Measured vs Predicted Energy Expenditure in Mechanically Ventilated Adults With Acute, Traumatic Spinal Cord Injuries. PG - 464-471 LID - 10.1002/ncp.10609 [doi] AB - BACKGROUND: Research regarding the impact of acute spinal cord injury (aSCI) on energy expenditure is limited. Patients with aSCI are prone to complications of both over- and under-feeding, making appropriate nutrition support pivotal to patient care. The purpose of this study was to describe energy expenditure and assess the performance of predictive equations in mechanically ventilated adults with aSCI. METHODS: Adult patients admitted to a single trauma center from March 2017 through June 2018 with aSCI and a documented indirect calorimetry (IC) within 6 weeks of injury were included for analysis. Predictive equations evaluated included Penn State 2003b (PS 2003b), the derived Weir equation, 25 kcal/kg and 30 kcal/kg. Sub-set analysis was performed for patients with and without obesity, isolated aSCI, and concomitant traumatic injuries. RESULTS: On hundres fifteen IC studies in 51 patients were included for analysis. Median energy expenditure was 1747 kcal/day (interquartile range [IQR], 1492-2099 kcal/day), or 22.7 kcal/kg (IQR, 19.3-25.9 kcal/kg). When stratified by hospital day, energy expenditure ranged from 20 to 25 kcal/kg. PS 2003b and the derived Weir equation had similar correlation coefficients (r = 0.81 and 0.82, respectively). The 25 and 30 kcal/kg performed unacceptably (r = 0.61). PS 2003b predicted within 10% of measured energy expenditure most frequently. All equations were biased towards overfeeding, except for PS 2003b in the obese subset. CONCLUSION: In the absence of IC, PS 2003b or the derived Weir equation may be acceptable predictive equations in this population. However, bedside clinicians should monitor carefully for signs and symptoms of overfeeding. CI - (c) 2020 American Society for Parenteral and Enteral Nutrition. FAU - Pelekhaty, Stacy L AU - Pelekhaty SL AUID- ORCID: 0000-0002-8060-5389 AD - University of Maryland Medical Center, Baltimore, Maryland, USA. AD - R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA. FAU - Ramirez, Christine L AU - Ramirez CL AD - St. Luke's University Health Network, Bethlehem, Pennsylvania, USA. FAU - Massetti, Jennifer M AU - Massetti JM AD - R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA. FAU - Gaetani, Dino AU - Gaetani D AD - University of Maryland Medical Center, Baltimore, Maryland, USA. FAU - Riggin, Karen AU - Riggin K AD - University of Maryland Medical Center, Baltimore, Maryland, USA. AD - R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA. FAU - Schwartzbauer, Gary AU - Schwartzbauer G AD - University of Maryland Medical Center, Baltimore, Maryland, USA. FAU - Stein, Deb M AU - Stein DM AD - Zuckerberg San Francisco General, San Francisco, California, USA. LA - eng PT - Journal Article DEP - 20201209 PL - United States TA - Nutr Clin Pract JT - Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition JID - 8606733 SB - IM MH - Adult MH - Calorimetry, Indirect MH - Energy Metabolism MH - Humans MH - Nutritional Status MH - *Respiration, Artificial MH - *Spinal Cord Injuries/therapy OTO - NOTNLM OT - energy expenditure OT - indirect calorimetry OT - mechanical ventilation OT - nutrition support OT - predictive equations OT - spinal cord injury EDAT- 2020/12/11 06:00 MHDA- 2021/09/01 06:00 CRDT- 2020/12/10 06:01 PHST- 2020/12/11 06:00 [pubmed] PHST- 2021/09/01 06:00 [medline] PHST- 2020/12/10 06:01 [entrez] AID - 10.1002/ncp.10609 [doi] PST - ppublish SO - Nutr Clin Pract. 2021 Apr;36(2):464-471. doi: 10.1002/ncp.10609. Epub 2020 Dec 9.