Energy expenditure of patients on ECMO: A prospective pilot study
Abstract
Background An optimal nutritional approach sustained by convenient monitoring of metabolic status and reliable assessment of energy expenditure (EE) may improve the outcome of critically ill patients on extracorporeal membrane oxygenation (ECMO). We previously demonstrated the feasibility of indirect calorimetry (IC)-the standard of care technique to determine caloric targets-in patients undergoing ECMO. This study aims to compare measured with calculated EE during ECMO treatment. We additionally provide median EE values for use in settings where IC is not available. Methods IC was performed in seven stable ECMO patients. Gas exchange was analyzed at the ventilator, and ECMO side and values were introduced in a modified Weir formula to calculate resting EE. Results were compared with EE calculated with the Harris-Benedict equation and with the 25 kcal/kg/day ESPEN recommendation. Results Total median oxygen consumption rate was 196 (Q1-Q3 158-331) mL/min, and total median carbon dioxide production was 150 (Q1-Q3 104-203) mL/min. Clinically relevant differences between calculated and measured EE were observed in all patients. The median EE was 1334 (Q1-Q3 1134-2119) kcal/24 hours or 18 (Q1-Q3 15-27) kcal/kg/day. Conclusion Compared with measured EE, calculation of EE both over- and underestimated caloric needs during ECMO treatment. Despite a median EE of 21 kcal/kg/day, large variability in metabolic rate was found and demands further investigation.
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Indirect calorimetry may become inaccurate during ECMO support.
“Indirect calorimetry may become inaccurate during ECMO support,166,167”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [167]
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“Data were collected minute‐to‐minute for at least 30 minutes using breath‐by‐breath technology(9) and then inserted in a modified Weir formula software program.(9) Data are presented as median with percentiles (IQR) or as indicated in the legend.”
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“15, 2015 Austrália Estudo observacional prospectivo 107 Qualquer indicação 9 (5-12) 42 (31-56) Masculino 50,5% 25,8 (23-31) 13 (7-30) Gástrica 90% Entérica 10% METAS ESTIMADAS Calorias 2040 (1851-2391) kcal/dia Proteínas 95 (72-106) g/ dia APORTE RECEBIDO Calorias 1680 (960-2100) / 20 kcal/kg média Proteínas 72 (42-98…”
BackgroundInfluential
- Authors
- De Waele, E., Jonckheer, J., Pen, J. J., Demol, J., Staessens, K., Puis, L., La Meir, M., Honoré, P. M., L. N. G. Malbrain, M., & Spapen, H. D.
- Affiliations
- Intensive Care Unit, UZ Brussel Vrije Universiteit Brussel (VUB) Brussels Belgium
- Vrije Universiteit Brussel (BE)
- Department of cardiac surgery, UZ Brussel Vrije Universiteit Brussel (VUB) Brussels Belgium
- Venue
- Acta Anaesthesiologica Scandinavica
- Publisher
- Wiley
- Published
- 2018-11-06
- Volume
- 63
- Issue
- 3
- Pages
- 360-364
- ISSN
- 0001-5172 (ISSN-L)
- 1399-6576
- OpenAlex
- W2899840399
- Cited by
- 48
- References
- 0
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 4 · 2023: 7 · 2022: 8 · 2021: 10 · 2020: 4 · 2019: 2
- FWCI
- 3.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Acta Anaesthesiologica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Physical Sciences › Engineering › Biomedical Engineering › Mechanical Circulatory Support Devices
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- extracorporeal membrane oxygenation, energy expenditure, indirect calorimetry, resting energy expenditure, Harris-Benedict equation, oxygen consumption, CO2 emissions, critically ill patients, nutritional support, metabolic rate
- MeSH terms
- Aged, Calorimetry, Indirect, Carbon Dioxide, Energy Metabolism, Female, Humans, Male, Middle Aged, Oxygen Consumption, Pilot Projects, Prospective Studies, Pulmonary Gas Exchange, Rest, Extracorporeal Membrane Oxygenation, Critical Illness
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