Indirect calorimetry in nutritional therapy. A position paper by the ICALIC study group
Open accessAbstract
Background & aims This review aims to clarify the use of indirect calorimetry (IC) in nutritional therapy for critically ill and other patient populations. It features a comprehensive overview of the technical concepts, the practical application and current developments of IC. Methods Pubmed-referenced publications were analyzed to generate an overview about the basic knowledge of IC, to describe advantages and disadvantages of the current technology, to clarify technical issues and provide pragmatic solutions for clinical practice and metabolic research. The International Multicentric Study Group for Indirect Calorimetry (ICALIC) has generated this position paper. Results IC can be performed in in- and out-patients, including those in the intensive care unit, to measure energy expenditure (EE). Optimal nutritional therapy, defined as energy prescription based on measured EE by IC has been associated with better clinical outcome. Equations based on simple anthropometric measurements to predict EE are inaccurate when applied to individual patients. An ongoing international academic initiative to develop a new indirect calorimeter aims at providing innovative and affordable technical solutions for many of the current limitations of IC. Conclusion Indirect calorimetry is a tool of paramount importance, necessary to optimize the nutrition therapy of patients with various pathologies and conditions. Recent technical developments allow broader use of IC for in- and out-patients.
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Experts concur that caloric goals should be individualized and require an exact estimate of resting energy expenditure (REE) performed with indirect calorimetry (IC) as the gold standard.
“Experts concur that caloric goals should be individualized and require an exact estimate of resting energy expenditure (REE) performed with indirect calorimetry (IC) as the gold standard [13].”
From Nutrition in Sepsis: A Bench-to-Bedside Review. (2020) · cites this paper as [13]
Bedside use of IC remains limited due to a lack of device standardization, erroneous results due to system leaks, and high inspired oxygen levels during mechanical ventilation, and logistic challenges (e.g., the need to repeat measurements over time).
“Overall, bedside use of IC remains limited due to a lack of device standardization, erroneous results due to system leaks, and high inspired oxygen levels during mechanical ventilation, and logistic challenges (e.g., the need to repeat measurements over time).”
From Nutrition in Sepsis: A Bench-to-Bedside Review. (2020) · cites this paper as [13]
Energy debt, representing the difference between energy need and intake, is strongly correlated with complications and/or reduced survival.
“Such a condition is associated with the development of a progressively increasing energy debt, representing the difference between energy need and intake, strongly correlated with complications and/or reduced survival (89,91,323,324).”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [323]
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“A patient should be in a resting condition or at least be able to keep calm during most of the IC duration [26], for the results to be a true representative value of the resting EE.”
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Self-citation
- Authors
- Oshima, T., Berger, M. M., De Waele, E., Guttormsen, A. B., Heidegger, C.-P., Hiesmayr, M., Singer, P., Wernerman, J., & Pichard, C.
- Affiliations
- Chiba University (JP)
- Centre Hospitalier Universitaire Vaudois (CH)
- Haukeland University Hospital (NO)
- University Hospital of Geneva (CH)
- University of Vienna (AT)
- Rabin Medical Center (IL)
- Karolinska University Hospital (SE)
- Corresponding author
- Oshima, Taku
- Berger, Mette M.
- Guttormsen, Anne Berit
- Heidegger, Claudia-Paula
- Hiesmayr, Michael
- Singer, Pierre
- Wernerman, Jan
- Pichard, Claude
- ORCID
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2017-06
- Volume
- 36
- Issue
- 3
- Pages
- 651-662
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2468756528
- Cited by
- 283
- References
- 78
- Citations by year
- 2026: 29 · 2025: 38 · 2024: 33 · 2023: 30 · 2022: 28 · 2021: 24 · 2020: 30 · 2019: 32 · 2018: 22 · 2017: 14 · 2016: 3
- FWCI
- 21.10
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Keywords
- indirect calorimetry, energy expenditure, nutritional therapy, critically ill patients, anthropometric equations, intensive care nutrition, metabolic studies
- MeSH terms
- Calorimetry, Indirect, Energy Metabolism, Humans, Inpatients, Intensive Care Units, Nutritional Requirements, Outpatients, Rest, Databases, Factual, Critical Illness, Nutritional Support
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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