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2024, Number 6

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Med Crit 2024; 38 (6)

Indirect calorimetry versus calculation of caloric requirement by measurement of MVCO2 given by mechanical ventilator

Chávez DGR, Dector LDM, Enríquez SD, Alva AN, Mercado CE

Language: Spanish
References: 39
Page: 478-485
PDF size: 308.73 Kb.


ABSTRACT

Introduction: monitoring critically ill patients requires optimal monitoring of energy requirements to determine the ideal nutritional intake according to the clinical condition, support early improvement, and reduce complications. Caloric requirements depend on the individual characteristics of each patient, such as pathology, and sedation, among others. Over time, several techniques have been developed to determine this requirement, such as the one calculated from MVCO2, a parameter provided by the mechanical ventilator, to continuous indirect calorimetry, the latter being the gold standard for this purpose. Objective: to compare the measurement of basal energy requirement obtained by indirect calorimetry in patients with invasive ventilatory support and the energy requirement calculated from MVCO2 measured with a Drager ventilator in patients with invasive ventilatory support. Material and methods: a prospective cross-sectional study was developed in the Intensive Care Unit of the Dalinde Medical Center. It included patients with advanced airway support who had indirect calorimetry software and ventilation support provided by a Drager ventilator with MVCO2 measurement, with which the caloric requirement calculation was performed. Results: the energy requirement calculated by MVCO2 was 141.35 ± 32, and given by indirect calorimetry was 141.67 ± 26.5. A difference of means analysis was performed for both methods and did not find statistically significant differences (p-value of 0.907 and p-value of 0.091). Conclusion: there is a percentage relationship between the data from energy requirement calculated by indirect calorimetry and calculated from the production of MVCO2 by the Draguer ventilator. Therefore, calculating the caloric requirement by measuring MVCO2 given by a mechanical ventilator is an adequate alternative for critically ill patients hospitalized in units that do not have indirect calorimetry.


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