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Metabolic Rate in Older Critically Ill Patient

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Diet and Nutrition in Critical Care
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Abstract

Age is a known factor in determining resting metabolic rate in healthy people. Resting metabolic rate falls as age increases. The decrease seems to be associated with an age-dependent decrease in fat-free mass rather than a decrease in metabolic rate per unit of mass. This decrease in resting metabolic rate is captured in many predictive equations, which have a variable for age. A surprisingly limited amount of data exists on the resting metabolic rate of elderly critically ill patients. In one small study of trauma patients, the resting metabolic rate was reduced in older patients compared to younger, but the decrease was proportional to the expected decrease in resting metabolic rate in healthy aging. The incidence of fever was also lower in the older patients. In a much larger sample of trauma, surgical, and medical critical care patients prepared for this chapter, a lower body temperature and resting metabolic rate were again noted. The resting metabolic rate difference remained even after controlling for age, body size, and body temperature. Resting metabolic rate in the critically ill patient is predicted almost as well in the elderly as in the young.

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References

  • Academy of Nutrition and Dietetics Evidence Analysis Library. http://andevidencelibrary.com/template.cfm?template=guide_summary&key=3200. Accessed 5 July 2013.

  • Alix E, Berrut G, Bor M, Bouthier-Quintard F, Buia JM, Chlala A, Cldeat Y, D’Orsay G, Lavigne C, Levasseur R, Mouzet JB, Ombredanne MP, Salle A, Gaillard C, Ritz P. Energy requirements in hospitalized elderly patients. J Am Geriatr Soc. 2007;55:1085–9.

    Article  PubMed  Google Scholar 

  • Bosy-Westphal A, Eichorn C, Kutzner D, Illner K, Heller M, Muller MJ. The age-related decline in resting energy expenditure in humans is due to the loss of fat-free mass and to alterations in its metabolically active components. J Nutr. 2003;133:2356–62.

    CAS  PubMed  Google Scholar 

  • Boullata J, Williams J, Cottrell F, Hudson L, Compher C. Accurate determination of energy needs in hospitalized patients. J Am Diet Assoc. 2007;107:393–401.

    Article  PubMed  Google Scholar 

  • Frankenfield DC. On heat, respiration, and calorimetry. Nutrition. 2010;26:939–50.

    Article  PubMed  Google Scholar 

  • Frankenfield DC. Validation of a metabolic rate equation in older obese critically ill people. JPEN J Parenter Enteral Nutr. 2011;35:264–9.

    Article  PubMed  Google Scholar 

  • Frankenfield DC. Bias and accuracy of resting metabolic rate equations in non-obese and obese adults. Clin Nutr. 2013. doi:10.1016/j.clnu.2013.03.022.

    PubMed  Google Scholar 

  • Frankenfield DC, Cooney RN, Smith JS. Effect of aging on the metabolic response to traumatic injury. J Trauma. 2000;48:49–57.

    Article  CAS  PubMed  Google Scholar 

  • Frankenfield DC, Smith JS, Cooney RN, Blosser SA. Relative association of fever and injury with hypermetabolism in critically ill patients. Injury. 1997;28:617–621.

    Article  CAS  PubMed  Google Scholar 

  • Frankenfield DC, Schubert A, Alam S, Cooney RN. Validation study of predictive equations for resting metabolic rate in critically ill patients. JPEN J Parenter Enteral Nutr. 2009;33:27–36.

    Article  PubMed  Google Scholar 

  • Frankenfield DC, Ashcraft CM, Galvan DA. Longitudinal prediction of metabolic rate in critically ill patients. JPEN J Parenter Enteral Nutr. 2012;36:700–12.

    Article  PubMed  Google Scholar 

  • Frankenfield DC, Ashcraft CM, Galvan DA. Prediction of resting metabolic rate in critically ill patients at the extremes of body mass index. JPEN J Parenter Enteral Nutr. 2013;37:361–7. doi:10.1177/0148607112457423.

    Article  PubMed  Google Scholar 

  • Gariballa S, Forster S. Energy expenditure of acutely ill hospitalized patients. J Nutr. 2006;5:9–13.

    Article  Google Scholar 

  • Greenberg S. A profile of older Americans: 2011. Administration on Aging, US Department of Health and Human Services.

    Google Scholar 

  • Harris JA, Benedict FG. A biometric study of basal metabolism in man. Publication no. 279, Washington, DC: Carnegie Institute; 1919.

    Google Scholar 

  • Heyland DK, Dhaliwal R, Drover JW, et al. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr 2003;27(5):355–373. Canadian clinical practice guidelines-updated summary of topics and recommendations http://www.criticalcarenutrition.com/docs/cpg/srrev.pdf

  • Kreymann KG, Berger MM, Deutz NE, et al. ESPEN guidelines on enteral nutrition: intensive care. Clin Nutr. 2006;25(2):210–23.

    Article  CAS  PubMed  Google Scholar 

  • Long CL, Schaffel N, Geiger JW, et al. Metabolic response to injury and illness: estimation of energy and protein needs from indirect calorimetry and nitrogen balance. JPEN J Parenter Enteral Nutr. 1979;3:452.

    Article  CAS  PubMed  Google Scholar 

  • MacDonald A, Hildebrandt L. Comparison of formulaic equations to determine energy expenditure in the critically ill patient. Nutrition. 2003;19:233.

    Article  PubMed  Google Scholar 

  • McClave SA, Martindale RG, Vanek VW, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2009;33(3):277–316.

    Article  PubMed  Google Scholar 

  • Mifflin MD, St. Jeor ST, Hill LA, Scott BJ, Daugherty SA, Koh YO. A new predictive equation for resting energy expenditure in healthy individuals. Am J Clin Nutr. 1990;51:241–7.

    Google Scholar 

  • Paillaud E, Bories PN, Le Parco JC, Campillo B. Nutritional status and energy expenditure in elderly patients with recent hip fracture during a 2-month follow-up. Br J Nutr. 2000;83:97–103.

    CAS  PubMed  Google Scholar 

  • Raubenheimer D. Problems with ratio analysis in nutritional studies. Funct Ecol. 1995;9:21–9.

    Article  Google Scholar 

  • Savard JF, Faisy C, Lerolle N, Guerot E, Diehl JL, Fagon JY. Validation of a predictive method for an accurate assessment of resting energy expenditure in medical mechanically ventilated patients. Crit Care Med. 2008;36:1175–83.

    Article  PubMed  Google Scholar 

  • Sheridan R, Prelack K, Yin LY, Riggi V. Energy needs are poorly predicted in critically ill elderly. J Intensive Care Med. 1997;12:45–9.

    Article  Google Scholar 

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Correspondence to David C. Frankenfield .

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Frankenfield, D.C. (2015). Metabolic Rate in Older Critically Ill Patient. In: Rajendram, R., Preedy, V.R., Patel, V.B. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7836-2_48

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  • DOI: https://doi.org/10.1007/978-1-4614-7836-2_48

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7837-9

  • Online ISBN: 978-1-4614-7836-2

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