TY - JOUR
T1 - Effects of Energy Delivery Guided by Indirect Calorimetry in Critically Ill Patients
T2 - A Systematic Review and Meta-Analysis
AU - Watanabe, Shinichi
AU - Izumino, Hiroo
AU - Takatani, Yudai
AU - Tsutsumi, Rie
AU - Suzuki, Takahiro
AU - Tatsumi, Hiroomi
AU - Yamamoto, Ryo
AU - Sato, Takeaki
AU - Miyagi, Tomoka
AU - Miyajima, Isao
AU - Nakamura, Kensuke
AU - Higashibeppu, Naoki
AU - Kotani, Joji
PY - 2024/5/11
Y1 - 2024/5/11
N2 - BACKGROUND: The utility of using indirect calorimetry (IC) to estimate energy needs and methods for its application to this purpose remain unclear. This systematic review investigated whether using IC to estimate energy expenditure in critically ill patients is more meaningful for improving survival than other estimation methods. METHODS: Comprehensive searches were conducted in MEDLINE using PubMed, Cochrane Central Register of Controlled Trials, and Igaku-Chuo-Zasshi up to March 2023. RESULTS: Nine RCTs involving 1178 patients were included in the meta-analysis. The evidence obtained suggested that energy delivery by IC improved short-term mortality (risk ratio, 0.86; 95% confidence interval [CI], 0.70 to 1.06). However, the use of IC did not appear to affect the length of ICU stay (mean difference [MD], 0.86; 95% CI, -0.98 to 2.70) or the duration of mechanical ventilation (MD, 0.66; 95% CI, -0.39 to 1.72). Post hoc analyses using short-term mortality as the outcome found no significant difference by target calories in resting energy expenditure, whereas more frequent IC estimates were associated with lower short-term mortality and were more effective in mechanically ventilated patients. CONCLUSIONS: This updated meta-analysis revealed that the use of IC may improve short-term mortality in patients with critical illness and did not increase adverse events.
AB - BACKGROUND: The utility of using indirect calorimetry (IC) to estimate energy needs and methods for its application to this purpose remain unclear. This systematic review investigated whether using IC to estimate energy expenditure in critically ill patients is more meaningful for improving survival than other estimation methods. METHODS: Comprehensive searches were conducted in MEDLINE using PubMed, Cochrane Central Register of Controlled Trials, and Igaku-Chuo-Zasshi up to March 2023. RESULTS: Nine RCTs involving 1178 patients were included in the meta-analysis. The evidence obtained suggested that energy delivery by IC improved short-term mortality (risk ratio, 0.86; 95% confidence interval [CI], 0.70 to 1.06). However, the use of IC did not appear to affect the length of ICU stay (mean difference [MD], 0.86; 95% CI, -0.98 to 2.70) or the duration of mechanical ventilation (MD, 0.66; 95% CI, -0.39 to 1.72). Post hoc analyses using short-term mortality as the outcome found no significant difference by target calories in resting energy expenditure, whereas more frequent IC estimates were associated with lower short-term mortality and were more effective in mechanically ventilated patients. CONCLUSIONS: This updated meta-analysis revealed that the use of IC may improve short-term mortality in patients with critical illness and did not increase adverse events.
KW - critically ill patients
KW - indirect calorimetry
KW - meta-analysis
UR - https://www.scopus.com/pages/publications/85194218843
UR - https://www.scopus.com/inward/citedby.url?scp=85194218843&partnerID=8YFLogxK
U2 - 10.3390/nu16101452
DO - 10.3390/nu16101452
M3 - Article
C2 - 38794690
AN - SCOPUS:85194218843
SN - 2072-6643
VL - 16
JO - Nutrients
JF - Nutrients
IS - 10
ER -