ArticleCritical care (London, England)2015
Ventilator-derived carbon dioxide production to assess energy expenditure in critically ill patients: proof of concept.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02815527 (Time to Protein Target, the 'HIGH WHEY' Study A Prospective Pilot Study), which is not on this map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Time to Protein Target, the 'HIGH WHEY' Study A Prospective Pilot Study
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic and application guidelines for malnutrition in adult patients (2025 edition).Asia Pacific journal of clinical nutrition · 2025Guideline
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- Runaway uncoupling in 2,4-dinitrophenol poisoning: Clinical and mitochondrial observations from two cases.Toxicology reports · 2026Article
- Energy expenditure measurement in critical care: Implications for personalized nutrition support.World journal of critical care medicine · 2025Article
- Use of carbon dioxide production to detect bacterial superinfections in mechanically ventilated patients with acute respiratory distress syndrome: an exploratory prospective cohort study.BMJ open respiratory research · 2025Observational
- Validation of the capnodynamic method to calculate mixed venous oxygen saturation in postoperative cardiac patients.Intensive care medicine experimental · 2025Article
- Optimize individualized energy delivery for septic patients using predictive deep learning models.Asia Pacific journal of clinical nutrition · 2024Article
- Energy expenditure in COVID-19 mechanically ventilated patients: A comparison of three methods of energy estimation.JPEN. Journal of parenteral and enteral nutrition · 2022Article
- External Validation with Accuracy Confounders of VCONutrients · 2022Article
- Nutrition support for critically ill patients during the COVID-19 pandemic: the Italian SIAARTI survey.Journal of anesthesia, analgesia and critical care · 2022Article
- A new high protein-to-energy enteral formula with a whey protein hydrolysate to achieve protein targets in critically ill patients: a prospective observational tolerability study.European journal of clinical nutrition · 2022Observational
- A methodological and clinical approach to measured energy expenditure in the critically ill pediatric patient.Frontiers in pediatrics · 2022Review
- Energy expenditure and indirect calorimetry in critical illness and convalescence: current evidence and practical considerations.Journal of intensive care · 2021Review
- An Unobstructive Sensing Method for Indoor Air Quality Optimization and Metabolic Assessment within Vehicles.Sensors (Basel, Switzerland) · 2020Article
- Methods for Estimating Energy Expenditure in Critically Ill Adults.AACN advanced critical care · 2020Article
- Article
- Advances in Medical Nutrition Therapy: Parenteral Nutrition.Nutrients · 2020Review
- Association of PROtein and CAloric Intake and Clinical Outcomes in Adult SEPTic and Non-Septic ICU Patients on Prolonged Mechanical Ventilation: The PROCASEPT Retrospective Study.JPEN. Journal of parenteral and enteral nutrition · 2020Article
- Nutrition therapy in critical illness: a review of the literature for clinicians.Critical care (London, England) · 2020Review
- The effect of cisatracurium infusion on the energy expenditure of critically ill patients: an observational cohort study.Critical care (London, England) · 2020Observational
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMeasurement of energy expenditure (EE) is recommended to guide nutrition in critically ill patients. Availability of a gold standard indirect calorimetry is limited, and continuous measurement is unfeasible. Equations used to predict EE are inaccurate. The purpose of this study was to provide proof of concept that EE can be accurately assessed on the basis of ventilator-derived carbon dioxide production (VCO2) and to determine whether this method is more accurate than frequently used predictive equations.
methodsIn 84 mechanically ventilated critically ill patients, we performed 24-h indirect calorimetry to obtain a gold standard EE. Simultaneously, we collected 24-h ventilator-derived VCO2, extracted the respiratory quotient of the administered nutrition, and calculated EE with a rewritten Weir formula. Bias, precision, and accuracy and inaccuracy rates were determined and compared with four predictive equations: the Harris-Benedict, Faisy, and Penn State University equations and the European Society for Clinical Nutrition and Metabolism (ESPEN) guideline equation of 25 kcal/kg/day.
resultsMean 24-h indirect calorimetry EE was 1823 ± 408 kcal. EE from ventilator-derived VCO2 was accurate (bias +141 ± 153 kcal/24 h; 7.7 % of gold standard) and more precise than the predictive equations (limits of agreement -166 to +447 kcal/24 h). The 10 % and 15 % accuracy rates were 61 % and 76 %, respectively, which were significantly higher than those of the Harris-Benedict, Faisy, and ESPEN guideline equations. Large errors of more than 30 % inaccuracy did not occur with EE derived from ventilator-derived VCO2. This 30 % inaccuracy rate was significantly lower than that of the predictive equations.
conclusionsIn critically ill mechanically ventilated patients, assessment of EE based on ventilator-derived VCO2 is accurate and more precise than frequently used predictive equations. It allows for continuous monitoring and is the best alternative to indirect calorimetry.
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