• Erin K Kross, Matthew Sena, Karyn Schmidt, and Renee D Stapleton.
• Division of Pulmonary and Critical Care Medicine, University of Washington Medical Center, Seattle, WA 98104, USA. ekross@u.washington.edu
• J Crit Care. 2012 Jun 1; 27 (3): 321.e5-12.

PurposeMultiple equations exist for predicting resting energy expenditure (REE). The accuracy of these for estimating energy requirements of critically ill patients is not clear, especially for obese patients. We sought to compare REE, calculated with published formulas, with measured REE in a cohort of mechanically ventilated subjects.Materials And MethodsWe retrospectively identified all mechanically ventilated patients with measured body mass index who underwent indirect calorimetry in the intensive care unit. Limits of agreement and Pitman's test of difference in variance were performed to compare REE by equations with REE measured by indirect calorimetry.ResultsA total of 927 patients were identified, including 401 obese patients. There were bias and poor agreement between measured REE and REE predicted by the Harris-Benedict, Owen, American College of Chest Physicians, and Mifflin equations (P > .05). There was poor agreement between measured and predicted REE by the Ireton-Jones equation, stratifying by sex. Ireton-Jones was the only equation that was unbiased for men and those in weight categories 1 and 2. In all cases except Ireton-Jones, predictive equations underestimated measured REE.ConclusionNone of these equations accurately estimated measured REE in this group of mechanically ventilated patients, most underestimating energy needs. Development of improved predictive equations for adequate assessment of energy needs is needed.Copyright © 2012 Elsevier Inc. All rights reserved.

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