Gas-exchange and resting energy expenditure measurement with indirect calorimetry in children supported with non-invasive ventilation
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Data di Pubblicazione:
2019
Citazione:
Gas-exchange and resting energy expenditure measurement with indirect calorimetry in children supported with non-invasive ventilation / G.C.I. Spolidoro, V. D'Oria, C.V. Agostoni, T. Marchesi, S. Scalia Catenacci, L. Ughi, C. Montani, G. Chidini, T. Langer, E. Calderini. ((Intervento presentato al 30. convegno SMART tenutosi a Milano nel 2019.
Abstract:
Introduction. Nutrition plays a fundamental role in critically ill children and personalized nutritional therapy requires the measurement of resting energy expenditure (REE) [1-2]. Indirect calorimetry (IC) is the gold standard for REE assessment and is based on VO2 and VCO2 measurements. Furthermore, IC provides information on carbohydrates/lipids consumption by defining the respiratory quotient (RQ). However, while IC is validated for spontaneously breathing and mechanically ventilated patients, it is not for patients undergoing non-invasive ventilation (NIV) [3].
Aim of the study is therefore to validate IC for children undergoing NIV by comparing IC results obtained during spontaneous breathing with data gathered during NIV-CPAP (continuous positive airway pressure).
Methods. Patients (age <6 years) admitted to our pediatric intensive care unit (PICU) and weaning from NIV-CPAP were enrolled. Two IC measurements (Canopy mode) were performed for 20 minutes in randomized order in the following conditions: 1) Spontaneous breathing (SB), 2) NIV-CPAP (performed by single-limb circuit and vented mask). Average values for VCO2 , VO2, RQ and REE were obtained in the two conditions. Comparison between groups was performed via paired t-test. Agreement was assessed via Bland-Altman analysis. Statistical significance was defined as p<0.05.
Results. Four patients (median age 8 months, median weight 8 kg) were enrolled. VCO2 , VO2, RQ and REE did not differ significantly between groups. Limits of agreement (LOA) and BIAS indicate a good agreement between the two measures (Table 1).
Conclusions. Our preliminary data suggest that IC can be accurately performed in children undergoing NIV using a single limb circuit with intentional leaks. These results need to be confirmed on a broader cohort of critically ill children.
References
1. De Cosmi V et al. Nutrients. 2017, 18:9
2. Mehta NM et al. Pediatr Crit Care Med. 2017, 18:675-715
3. Taku Oshima et al. Clinical Nutr 2017; 36:651-662
Tipologia IRIS:
14 - Intervento a convegno non pubblicato
Elenco autori:
G.C.I. Spolidoro, V. D'Oria, C.V. Agostoni, T. Marchesi, S. Scalia Catenacci, L. Ughi, C. Montani, G. Chidini, T. Langer, E. Calderini
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