Premium
Handheld Calorimeter Is a Valid Instrument to Quantify Resting Energy Expenditure in Hospitalized Cirrhotic Patients
Author(s) -
Glass Cathy,
Hipskind Peggy,
Cole Denise,
Lopez Rocio,
Dasarathy Srinivasan
Publication year - 2012
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533612446195
Subject(s) - medicine , resting energy expenditure , energy expenditure , calorimeter (particle physics) , mobile device , medical physics , electrical engineering , engineering , detector , computer science , operating system
Background : Nutrition management of cirrhosis in hospitalized patients is overlooked despite the clinical significance of sarcopenia or loss of muscle mass in cirrhosis. Determining optimal nutrition requirement needs precise measurement of resting energy expenditure (REE) in the cirrhotic patient. Predictive equations are not accurate, and the metabolic cart is expensive and cumbersome. The authors therefore performed a prospective study to examine the feasibility and accuracy of a handheld respiratory calorimeter (HHRC) in quantifying the REE in hospitalized cirrhotic patients not in the intensive care unit. Materials and Methods : The study was done in 2 phases: in the first phase, the REE of 24 consecutive healthy volunteers was measured using an HHRC in different positions. The objective of this phase was to identify the impact of body and arm position on measured REE. Subsequently, in the second phase of the study, REE was measured using the HHRC and the metabolic cart in 25 consecutive well‐characterized, hospitalized cirrhotic patients. The degree of concordance was calculated. Results : Body position and arm position did not significantly affect the measured REE using HHRC. In patients with cirrhosis, the mean measured REE (kcal/d) using the HHRC was 1453.2 ± 319.3 in the hospital room, 1525.6 ± 305.2 in a quiet environment, and 1553.7 ± 270.6 with the metabolic cart ( P > .1). Predicted REE using 2 widely used equations did not correlate either with each other or with the measured REE. Conclusions : HHRC is a valid, feasible, and rapid method to determine optimal caloric needs in hospitalized cirrhotic patients)