Indirect calorimetry for metabolic monitoring in intensive care units

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There is currently no clear approach to determining the severity of surgical stress and its impact on cardiopulmonary system, as well as to assessing the adequacy of intensive care. Indirect calorimetry is increasingly used as an alternative to generally accepted methods. This technique is valuable for monitoring of energy requirements at the bedside. This review is devoted to indirect calorimetry for non-invasive monitoring of key metabolic parameters in intensive care units. The authors analyzed the main directions for indirect calorimetry in the operating theater and intensive care unit with a focus on assessment of cardiopulmonary oxygen transport.

Keywords:

indirect calorimetry

cardiorespiratory system

oxygen consumption

Fick method

aerobic metabolism

Authors:

Sorokina L.S.

Petrovsky National Research Centre of Surgery

ORCID: 0000-0001-5809-8563

Yudina S.S.

Petrovsky National Research Centre of Surgery

ORCID: 0000-0002-4292-5306

Petrov A.S.

Petrovsky National Research Centre of Surgery

ORCID: 0009-0005-8124-8693

Eremenko A.A.

Petrovsky National Research Centre of Surgery;
Sechenov First Moscow State Medical University

ORCID: 0000-0001-5809-8563

Received:

23.09.2024

Accepted:

11.10.2024

List of references:

Singer P, Blaser AR, Berger MM, Calder PC, Casaer M, Hiesmayr M, Mayer K, Montejo-Gonzalez JC, Pichard C, Preiser JC, Szczeklik W, van Zanten ARH, Bischoff SC. ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit. Clinical Nutrition. 2023:42(9):1671-1689. https://doi.org/10.1016/j.clnu.2023.07.011
Shea MG, Balaji L, Grossestreuer AV, Issa MS, Silverman J, Li F, Donnino MW, Berg KM. Oxygen metabolism after cardiac arrest: Patterns and associations with survival. Resuscitation Plus. 2024;19:100667. https://doi.org/10.1016/j.resplu.2024.100667
Uber A, Grossestreuer AV, Ross CE, Patel PV, Trehan A, Donnino MW, Berg KM. Preliminary observations in systemic oxygen consumption during targeted temperature management after cardiac arrest. Resuscitation. 2018;127:89-94. https://doi.org/10.1016/j.resuscitation.2018.04.001
Hoeyer-Nielsen AK, Holmberg MJ, Grossestreuer AV, Yankama T, Branton JP, Donnino MW, Berg KM. Association Between the Oxygen Consumption: Lactate Ratio and Survival in Critically Ill Patients with Sepsis. Shock. 2021;55(6):775-781. https://doi.org/10.1097/SHK.0000000000001661
Hirayama I, Asada T, Yamamoto M, Hayase N, Hiruma T, Doi K. Changes in carbon dioxide production and oxygen uptake evaluated using indirect calorimetry in mechanically ventilated patients with sepsis. Critical Care. 2021;25(1):416. https://doi.org/10.1186/s13054-021-03830-z
van den Oever HLA, Kök M, Oosterwegel A, Klooster E, Zoethout S, Ruessink E, Langeveld B. Feasibility of critical care ergometry: Exercise data of patients on mechanical ventilation analyzed as nine-panel plots. Physiological Reports. 2022;10(5):e15213. https://doi.org/10.14814/phy2.15213
Jakobsson J, Norén C, Hagel E, Backheden M, Kalman S, Bartha E. Perioperative estimations of oxygen consumption from LiDCO™plus-derived cardiac output and Ca-cvO2 difference: Relationship with measurements by indirect calorimetry in elderly patients undergoing major abdominal surgery. PLoS One. 2024;19(7):e0272239. https://doi.org/10.1371/journal.pone.0272239
Weir V. A new method for calculating metabolic rate with special reference to protein metabolism. Journal of Physiology. 1949;109:1-9.
Diener JRC. Calorimetria indireta. Revista da Associacao Medica Brasileira. 1997;43(3):245-253. https://doi.org/10.1590/S0104-42301997000300013
Holdy KE. Monitoring energy metabolism with indirect calorimetry: instruments, interpretation, and clinical application. Nutrition in Clinical Practice. 2004;19(5):447-454. https://doi.org/10.1177/0115426504019005447
Sion-Sarid R, Cohen J, Houri Z, Singer P. Indirect calorimetry: A guide for optimizing nutritional support in the critically ill child. Nutrition. 2013;29(9):1094-1099. https://doi.org/10.1016/j.nut.2013.03.013
De Waele E, van Zwam K, Mattens S, Staessens K, Diltoer M, Honoré PM, Czapla J, Nijs J, La Meir M, Huyghens L, Spapen H. Measuring resting energy expenditure during extracorporeal membrane oxygenation: preliminary clinical experience with a proposed theoretical model. Acta Anaesthesiologica Scandinavica. 2015;59(10):1296-1302. https://doi.org/10.1111/aas.12564
Veraar C, Fischer A, Bernardi MH, Sulz I, Mouhieddine M, Dworschak M, Tschernko E, Lassnigg A, Hiesmayr M. Absent Metabolic Transition from the Early to the Late Period in Non-Survivors Post Cardiac Surgery. Nutrients. 2022;14(16):3366. https://doi.org/10.3390/nu14163366
Korchazhkina NB, Mikhaylova AA, Kovalev SA, Portnov VV, Rzhevskiy VS. Effectiveness of early rehabilitation techniques in programs of accelerated recovery of patients after surgical interventions. Fizioterapiya, bal’neologiya i reabilitatsiya. 2019;18(6):408-411. (In Russ.). https://doi.org/10.17816/1681-3456-2019-18-6-408-411
Uiba VV, Kotenko KV, Orlov GV. System application of nondrug programs correction of the metabolic syndrome. Fizioterapiya, bal’neologiya i reabilitatsiya. 2011;(1):40-42. (In Russ.).
Petrova MS, Ruzova TK, Kotenko KV, Korchazhkina NB. Dynamics of metabolic exchange parameters and blood circulation in the lower extremities after traction in patients with lumbosacral dorsopathies. Fyzioterapevt. 2013;6:25-30. (In Russ.).
Baza dannykh po lecheniyu i profilaktike metabolicheskogo sindroma i ozhireniya. Kotenko KV, Goryagin AO, Korchazhkina NB, Mikhailova AA. Svidetel’stvo o gosudarstvennoj registratsii bazy dannykh Rossijskoj Federatsii №2024622590: zayavl. 20.06.2024, opubl. 01.07.2024. (In Russ.).
Nagornev SN, Korchazhkina NB, Mikhailova AA, Benkov AA. Personalized use of therapeutic physical factors in patients with metabolic syndrome. Regenerative Biotechnologies, Preventive, Digital and Predictive Medicine. 2024;1(2):5-11. (In Russ.). https://doi.org/10.17116/rbpdpm202410215
Baza dannykh po primeneniyu meditsinskikh texnologij dlya monitoringa individual’nogo zdorov’ya i podderzhaniya aktivnogo dolgoletiya. Kotenko KV, Korchazhkina NB, Eremin II, et al. Svidetel’stvo o gosudarstvennoj registratsii bazy dannykh №2023623054 Rossijskoj Federatsii №2023622827: zayavl. 31.08.2023, opubl. 06.09.2023. (In Russ.).
Kotenko KV, Mikhailova AA, Badimova AV, Reshetova IV, Dymova OV, Eremin II, Korchazhkina NB. Determination of prognostically significant markers of prenosological detection of predictors of obesity and metabolic disorders. Voprosy kurortologii, fizioterapii i lechebnoj fizicheskoj kul’tury. 2023;100(5-2):21. (In Russ.).
Brandi LS, Oleggini M, Lachi S, Frediani M, Bevilacqua S, Mosca F, Ferrannini E. Energy metabolism of surgical patients in the early postoperative period: a reappraisal. Critical Care Medicne. 1988;16(1):18-22. https://doi.org/10.1097/00003246-198801000-00004
Svensson KL, Henriksson BA, Sonander HG, Stenqvist O. Metabolic gas exchange during aortocoronary bypass surgery using a double pump system and mechanical ventilation. A comparison between indirect calorimetry and invasive blood gas measurements using Fick’s principle. Acta Anaesthesiologica Scandinavica. 1991;35(3):185-189.
Ruan H, Tang Q, Yang Q, Hu F, Cai W. Resting Energy Expenditure Early after Cardiac Surgery and Validity of Predictive Equations: A Prospective Observational Study. Annals of Nutrition and Metabolism. 2021;77(5):271-278. https://doi.org/10.1159/000518676
Brandi LS, Bertolini R, Pieri M, Giunta F, Calafà M. Comparison between cardiac output measured by thermodilution technique and calculated by O2 and modified CO2 Fick methods using a new metabolic monitor. Intensive Care Medicine. 1997;23(8):908-915. https://doi.org/10.1007/s001340050431
Inadomi C, Terao Y, Yamashita K, Fukusaki M, Takada M, Sumikawa K. Comparison of oxygen consumption calculated by Fick’s principle (using a central venous catheter) and measured by indirect calorimetry. Journal of Anesthesiology. 2008;22(2):163-166. https://doi.org/10.1007/s00540-007-0588-9
Epstein CD, Peerless JR, Martin JE, Malangoni MA. Comparison of methods of measurements of oxygen consumption in mechanically ventilated patients with multiple trauma: the Fick method versus indirect calorimetry. Critical Care Medicne. 2000;28(5):1363-1369. https://doi.org/10.1097/00003246-200005000-00017
Walsh TS, Hopton P, Lee A. A comparison between the Fick method and indirect calorimetry for determining oxygen consumption in patients with fulminant hepatic failure. Critical Care Medicne. 1998;26(7): 1200-1207. https://doi.org/10.1097/00003246-199807000-00020
Keinänen O, Takala J. Calculated versus measured oxygen consumption during and after cardiac surgery. Is it possible to estimate lung oxygen consumption? Acta Anaesthesiologica Scandinavica. 1997;41(7):803-809. https://doi.org/10.1111/j.1399-6576.1997
Perfilova AV, Gromova TA, Lebedinskii KM, Zaichik AM. Oxygen consumption in the lungs and in the systemic circulation — different methods for assessing the same value or different values? Russian Journal of Anaesthesiology and Reanimatology. 2014;1:42-47. (In Russ.).

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