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Cited by 203Clinical Nutrition and GastroenterologySepsis Diagnosis and TreatmentHyperglycemia and glycemic control in critically ill and hospitalized patients

Components of energy expenditure in patients with severe sepsis and major trauma: A basis for clinical care

Uehara, Masanori, Plank, Lindsay D., Hill, Graham L.·1999·Critical Care Medicine
DOI 10.1097/00003246-199907000-00015
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Abstract

OBJECTIVE: To obtain accurate values for the components of energy expenditure in critically ill patients with sepsis or trauma during the first 2 wks after admission to the intensive care unit. DESIGN: Prospective study. SETTING: Critical care unit and university department of surgery in a single tertiary care center. PATIENTS: Twelve severely septic (median Acute Physiology and Chronic Health Evaluation II Score, 23; range, 15 to 34) and 12 major trauma patients (median Injury Severity Score, 33.5; range, 26 to 50). INTERVENTIONS: Total body fat, total body protein, and total body glycogen were measured as soon as hemodynamic stability had been reached and repeated 5 and 10 days later. Resting energy expenditure (REE) was measured daily by indirect calorimetry. MEASUREMENTS AND MAIN RESULTS: Changes in total body fat, total body protein, and total body glycogen in critically ill patients provide data for the accurate construction of an energy balance. Energy intake minus energy balance gives a direct measurement of total energy expenditure (TEE) and, when combined with measurements of REE, activity energy expenditure can be obtained. TEE, REE, and activity energy expenditure were calculated for two sequential 5-day study periods. REE progressively increased during the first week after the onset of severe sepsis or major trauma, peaking during the second week at 37 +/- 6% (SEM) and 60 +/- 13% greater than predicted, respectively. For both the sepsis and trauma patients, TEE was significantly higher during the second week than during the first week (3257 +/- 370 vs. 1927 +/- 370 kcal/day, p < .05, in sepsis; 4123 +/- 518 vs. 2380 +/- 422 kcal/day, p < .05, in trauma). During the first week after admission to the hospital, TEE in sepsis and trauma patients, respectively, averaged 25 +/- 5 and 31 +/- 6 kcal/kg of body weight/day, and during the second week, 47 +/- 6 and 59 +/- 7 kcal/kg/day (p < .03, for comparison of first and second weeks). For the first week, the ratio of TEE to REE was 1.0 +/- 0.2 and 1.1 +/- 0.2 but during the second week rose to 1.7 +/- 0.2 and 1.8 +/- 0.2 in patients with sepsis (p < .05, for comparison of weeks) and trauma (p = .09), respectively. CONCLUSIONS: Total energy expenditure is maximal during the second week after admission to the critical care unit, reaching 50 to 60 kcal/kg/day.

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Crossref · 10.1097/00003246-199907000-00015

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  • Old IC data demonstrated a steady increase of REE after sepsis onset, reaching a maximum of 1.7 times the baseline metabolism during the second week of ICU stay.

    “Old IC data indeed demonstrated a steady increase of REE after sepsis onset, reaching a maximum of 1.7 times the baseline metabolism during the second week of ICU stay [17].”

    From Nutrition in Sepsis: A Bench-to-Bedside Review. (2020) · cites this paper as [17]

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Authors
Uehara, M., Plank, L. D., & Hill, G. L.
Affiliations
University of Auckland (NZ)
ORCID
Plank, Lindsay D.
Venue
Critical Care Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1999-07
Volume
27
Issue
7
Pages
1295-1302
ISSN
0090-3493 (ISSN-L)
DOI
10.1097/00003246-199907000-00015
OpenAlex
W2014967429
Cited by
203
References
19
Citations by year
2026: 5 · 2025: 3 · 2024: 9 · 2023: 6 · 2022: 6 · 2021: 14 · 2020: 8 · 2019: 4 · 2018: 5 · 2017: 7 · 2016: 6 · 2015: 11 · 2014: 12 · 2013: 6 · 2012: 3
FWCI
5.61
Type
journal article
Language
en
Open access
closed
Locations
  • Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
Keywords
energy expenditure, severe sepsis, severe trauma, resting energy expenditure, total energy expenditure, physical activity energy expenditure, energy balance, fat mass, body protein, critically ill patients, intensive care unit, indirect calorimetry, energy intake
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Analysis of Variance, Body Composition, Calorimetry, Indirect, Critical Care, Energy Metabolism, Enteral Nutrition, Female, Humans, Male, Middle Aged, Monitoring, Physiologic, Neutron Activation Analysis, Nutritional Requirements, Prospective Studies, Radioisotope Dilution Technique, Wounds and Injuries, Absorptiometry, Photon, Critical Illness, Sepsis

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