This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Havalad, S. Articles by Sapiega, V. Search for Related Content PubMed PubMed Citation Articles by Havalad, S. Articles by Sapiega, V. Social Bookmarking                   What's this?

Energy Expenditure in Children With Severe Head Injury: Lack of Agreement Between Measured and Estimated Energy Expenditure

Division of Pediatric Critical Care Medicine, Department of Pediatrics, Advocate Lutheran General Children's Hospital, Park Ridge, Illinois

Correspondence: Suresh Havalad, MD, Division of Pediatric Critical Care Medicine, Department of Pediatrics, Advocate Lutheran General Children's Hospital, 1775 Dempster St, Park Ridge, IL 60068. Electronic mail may be sent to Suresh.Havalad-MD{at}advocatehealth.com.

Background: The purpose of this study was to test the hypotheses that estimates of resting energy expenditure (REE) vary significantly from measured energy expenditure in a population of head-injured children and are not accurate for use in determining nutrition needs in this population. Methods: This is a retrospective study of 30 children with severe head injury, with Glasgow Coma Scale (GCS) score of <8 and needing mechanical ventilation. Measured REE was obtained using indirect calorimetry. Estimated REEs were calculated using Harris-Benedict, World Health Organization (WHO), Schofield, and White formulas. Severity of illness was calculated using Pediatric Risk of Mortality (PRISM) score. Agreement between measured REE and estimated REE was tested using the Bland-Altman method. Correlation coefficient between PRISM score and measured REE was calculated using Spearman test. Results: More than half of the estimates of REE differed from measured REE by >10%. Significant disagreement between estimated REE and measured REE was demonstrated using the Bland-Altman method. There was no correlation between severity of illness and measured REE to explain the inaccuracies of REE estimates. Conclusion: Energy expenditure in critically ill children cannot be estimated accurately; hence, nutrition for critically ill children with head injury should be provided according to measurement of REE to avoid the consequences of overfeeding or malnutrition.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				H. E. Skillman and P. E. Wischmeyer Nutrition Therapy in Critically Ill Infants and Children JPEN J Parenter Enteral Nutr, September 1, 2008; 32(5): 520 - 534. [Abstract] [Full Text] [PDF]

				N. M. Mehta, L. J. Bechard, K. Leavitt, and C. Duggan Severe Weight Loss and Hypermetabolic Paroxysmal Dysautonomia Following Hypoxic Ischemic Brain Injury: The Role of Indirect Calorimetry in the Intensive Care Unit JPEN J Parenter Enteral Nutr, May 1, 2008; 32(3): 281 - 284. [Abstract] [Full Text] [PDF]