{"id":663,"date":"2013-01-01T15:42:52","date_gmt":"2013-01-01T20:42:52","guid":{"rendered":"https:\/\/med.virginia.edu\/ginutrition\/?p=663"},"modified":"2026-06-01T19:48:19","modified_gmt":"2026-06-01T23:48:19","slug":"january-2013-e-journal-club","status":"publish","type":"post","link":"https:\/\/med.virginia.edu\/ginutrition\/2013\/01\/01\/january-2013-e-journal-club\/","title":{"rendered":"January 2013 E-Journal Club"},"content":{"rendered":"

Greetings,<\/strong><\/p>\n

We generally do not plan for a training program in January because the fickle nature of the weather this time of year can make travel and schedules too much of an adventure.\u00a0 We have been trying to stay on schedule with our journal club however, because there have several new articles out that we want to be sure to include.<\/p>\n

January Citation:<\/strong><\/p>\n

Frankenfield DC, Ashcraft CM, Galvan DA.\u00a0 Longitudinal prediction of metabolic rate in critically ill patients.\u00a0 JPEN 2012;36(6):700-12.<\/p>\n

Summary:\u00a0<\/strong><\/p>\n

This study was designed to establish the cumulative error of the Penn State equation for estimation of energy expenditure of ICU patients over 7 days compared with daily measured calorie expenditure via indirect calorimetry (IC). The secondary goals were to measure the cumulative error of 25 kcal\/kg (American College of Chest Physicians – AACP) compared to daily indirect calorimetry, and also to measure the cumulative error of a single IC measurement compared with daily measurements of resting energy expenditure.<\/p>\n

The investigators tested a modified version of the Penn State equation designed for patients over 60 years who had a BMI > 30, because a previous study had demonstrated that the standard Penn State equation was not accurate in those patients.<\/p>\n

Adjusted weight (25% correction factor) was used for the AACP calculations when BMI was > 30.\u00a0 Variables used to calculate the Penn State equation were collected upon completion of the IC measurements, and weight used for calculations was the lower number of either the admission weight or weight upon study entry.<\/p>\n

Inclusion and Exclusion Criteria were:<\/strong><\/p>\n

Inclusion criteria<\/em>:<\/p>\n

Patients over 18 years in the surgical\/trauma, neuroscience, or medical ICU who were mechanically ventilated for at least 7 days and able to remain in a resting state during indirect calorimetry measurements.<\/p>\n

Exclusion criteria<\/em>:<\/p>\n

Patients with an air leak anywhere in the ventilator circuit (chest tubes, endotracheal cuffs, etc.) or those with a fraction of inspired oxygen > 60%.<\/p>\n

Major Results:<\/strong><\/p>\n

There were 32 patients evaluated who met inclusion criteria, and ultimately 13 patients were able to complete the full protocol (6 trauma, 3 neurologic\/neurosurgery, 2 sepsis, and 2 abdominal surgery).\u00a0 Six patients were > 60 years with a BMI > 30 (modified Penn State), and 7 entered the standard Penn State equation group.<\/p>\n

The mean cumulative difference between:<\/p>\n