Measuring energy requirements during pulmonary exacerbations of cystic fibrosis using indirect calorimetry

Published: 25 September 2023

The energy demands of individuals with cystic fibrosis (CF) vary depending on pancreatic function, body composition, lung function, and clinical status.

In clinical practice, predictive equations are used to determine energy requirements yet do not reliably account for these factors. Research regarding energy requirements during CF pulmonary exacerbation (CFPEx) and clinical stability is conflicting.

The aim of this study was to investigate potential within-individual changes in measured resting energy expenditure (mREE) using indirect calorimetry (IC) at the commencement and completion of intravenous antibiotic treatment (IVABx) for CFPEx and during clinical stability.

The mREE remained stable during CFPEx and clinical stability. The pREE underestimated mREE and application of injury factor adjustment of 110% to 130% could potentially account for this discrepancy. The potential role of IC and body composition in individualizing CF nutritional assessment and prescription requires further exploration.

This case highlights the importance of CPET in identifying hidden cardiopulmonary abnormalities contributing to post-COVID-19 dyspnea and provides further evidence that CPET should be used as a front-line test rather than an afterthought.

In conclusion, the CPET may be a useful method for resolving these diagnostic dilemmas, as in this case.

Article details:

- Title: Measuring energy requirements during pulmonary exacerbations of cystic fibrosis using indirect calorimetry
- Authors: Katelyn McCafferty, Jordan Henderson, Siobhain Mulrennan MBChB, Janica Jamieson, Catherine Properzi, Anna Tai.
- Published in: Nutrition. 2023 Aug;112:112073.
- DOI: 10.1016/j.nut.2023.112073