• Nutrition · Aug 2023

    Measuring energy requirements during pulmonary exacerbations of cystic fibrosis using indirect calorimetry.

    • Katelyn McCafferty, Jordan Henderson, Siobhain Mulrennan, Janica Jamieson, Catherine Properzi, and Anna Tai.
    • Adult Cystic Fibrosis Centre, Sir Charles Gairdner Hospital, Perth, Western Australia; Institute for Respiratory Health, Perth, Western Australia. Electronic address: katelyn.mccafferty@health.wa.gov.au.
    • Nutrition. 2023 Aug 1; 112: 112073112073.

    ObjectiveThe energy demands of individuals with cystic fibrosis (CF) vary depending on pancreatic function, body composition, lung function, and clinical status. In clinical practice, predictive equations are used to determine energy requirements yet do not reliably account for these factors. Research regarding energy requirements during CF pulmonary exacerbation (CFPEx) and clinical stability is conflicting. The aim of this study was to investigate potential within-individual changes in measured resting energy expenditure (mREE) using indirect calorimetry (IC) at the commencement and completion of intravenous antibiotic treatment (IVABx) for CFPEx and during clinical stability. Secondary aims were to investigate potential differences between predicted resting energy expenditure (pREE) using Schofield equation and correlations between clinical factors with mREE.MethodsBody composition using bioimpedance analysis and mREE were conducted at three time points: commencement of IVABx; completion of IVABx; and clinically stable period thereafter.ResultsTwenty-eight adults with CF completed at least one valid IC measurement. No significant within-person changes in mREE and body composition parameters were observed across time points. The mREE was positively correlated with fat-free mass (kg; r = 0.6; P = 0.008). The mREE was significantly higher than pREE at all time points with the mREE/pREE ratio elevated at time point 1:118% ± 19.5%; time point 2: 112% ± 13.2%; and time point 3: 122 ± 14.3%.ConclusionThe mREE remained stable during CFPEx and clinical stability. The pREE underestimated mREE and application of injury factor adjustment of 110% to 130% could potentially account for this discrepancy. The potential role of IC and body composition in individualizing CF nutritional assessment and prescription requires further exploration.Copyright © 2023 Elsevier Inc. All rights reserved.

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