The usefulness of a new indirect calorimeter in critically ill adult patients

Adequate nutrition is of paramount importance in critically ill patients, as it can result in less muscle wasting, decreased length of hospital stay and decreased mortality. 

Since metabolism, resting energy expenditure (REE) and nutritional status are changing during the different phases of critical illness, it is difficult to ensure adequate nutritional intake. Indirect calorimetry is considered the gold standard to determine energy requirements, because it individually determines REE based on oxygen consumption (VO2) and carbon dioxide production (VCO2). International nutrition guidelines highly recommend the use of indirect calorimetry in the intensive care unit (ICU), yet it is not commonly used.

The primary aim of this study was to describe the usefulness of the new and easy-to-use calorimeter (Q-NRG+, COSMED) in a large group of patients with COVID-19 during ICU stay.

The study results show how despite the logistical and critical issues limiting the use of this technology, the majority of the REE-measurements indicated either hypo- or hypermetabolism proving indirect calorimetry to be of added value to personalized nutritional support.