Predicting Resting Energy Expenditure in Critically Ill Patients by Measuring Lean Body Mass by US
- Conditions
- Resting Energy Expenditure
- Interventions
- Diagnostic Test: US Muscle layer thickness (MLT) estimationDiagnostic Test: REE estimation by indirect calorimetry
- Registration Number
- NCT03193632
- Lead Sponsor
- Eslam Ayman Mohamed Shawki
- Brief Summary
The study aims to correlate Lean Body Mass (LBM) Evaluated by Musculoskeletal Ultrasound with Resting Energy Expenditure (REE) measured by Indirect Calorimetry and to generate a predictive equation of REE based on LBM, in addition to identifying other factors that may affect REE such as age, gender, and severity scores.
- Detailed Description
Caloric needs in critically-ill patients fluctuate significantly over the course of the disease which might expose patients to either malnutrition or overfeeding.Malnutrition is associated with deterioration of lean body mass (LBM), poor wound healing, increased risk of nosocomial infection, and weakened respiratory muscles. On the other hand overfeeding in medically compromised patients can promote lipogenesis, hyperglycemia, and exacerbation of respiratory failure. Many factors may affect the resting energy expenditure (REE) through manipulation of oxygen consumption (VO2). One of the strongest determinants of REE is the LBM.
A measurement of muscle mass and changes in muscle mass could thus provide an index of LBM in critically ill patients. At present, computerized tomography, magnetic resonance imaging and dual-energy X-ray absorptiometry (DXA) are widely used as reference methods for evaluating LBM in vivo. However, these methods are impractical in critically ill patients. More practically, ultrasound scanning is a simple, portable, safe, and a low-patient burden technique. Several studies found that the use of ultrasound can be a good estimate to LBM.
Indirect calorimetry remains the accepted standard for determining the REE in the critically ill. Indirect calorimetry measures oxygen consumption(VO2) and carbon dioxide excretion (VCO2 ) (both in mL/min), which are used to calculate the respiratory quotient and the resting energy expenditure. Although, the measured LBM has been shown as an important determinant of REE, there was no previous study tested the relationship between estimated LBM by ultrasound-based muscle thickness measurement and REE.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 40
- Patient requiring ventilatory support > 24 hours
- Patient who will require FIO2 more than 0.6.
- Air leak from the chest tube.
- Patient with body temperature > 39oC.
- Patients with known endocrine dysfunction.
- Patients on parenteral nutrition
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Study group US Muscle layer thickness (MLT) estimation critically-ill patients who will be admitted to the surgical ICU for ventilatory support and will be expected to continue for more than one day US Muscle layer thickness (MLT) estimation will be used to estimate LBM and REE estimation by indirect calorimetry will be performed Study group REE estimation by indirect calorimetry critically-ill patients who will be admitted to the surgical ICU for ventilatory support and will be expected to continue for more than one day US Muscle layer thickness (MLT) estimation will be used to estimate LBM and REE estimation by indirect calorimetry will be performed
- Primary Outcome Measures
Name Time Method correlation between LBM derived from ultrasound MLT and REE by indirect calorimetry 24 hours of ICU admission The correlation of the LBM derived from ultrasound MLT to the REE measured within 24 hours of ICU admission with indirect calorimetry
- Secondary Outcome Measures
Name Time Method Predictive equation for REE based on US measurement of MLT 24 hours of ICU admission generation of predictive equation of REE based on ultrasound measurement of MLT
Estimation of the effect of severity scores on the REE 24 hours of ICU admission Estimation of the effect of severity scores on the REE
Trial Locations
- Locations (1)
Faculty of medicine, Cairo University teaching hospitals (Kasr Alainy)
🇪🇬Cairo, Egypt