Measured Energy Expenditure of Tube-Fed Patients with Severe Neurodevelopmental Disabilities

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Journal of the American College of Nutrition, ISSN: 1541-1087, Vol: 18, Issue: 1, Page: 61-68

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Dickerson, Roland N.; Brown, Rex O.; Gervasio, Jane M.; Hak, Emily B.; Hak, Lawrence J.; Williams, John E.
Informa UK Limited
Medicine; Nursing; enteral nutrition; calorimetry; intellectual disability; metabolism; neuromuscular disease; REE; resting energy expenditure; neurodevelopmental disabilities; Pharmacy and Pharmaceutical Sciences
article description
Objective: To determine measured resting energy expenditure (REE) of nonambulatory tube-fed patients with severe neurological neurodevelopmental disabilities. Methods: Twenty patients were prospectively studied. Only steady state indirect calorimetry measurements were taken. All measurements were conducted using a canopy system. Nutritional needs were met entirely by enteral feedings via a permanent ostomy. Results: REE was widely distributed from 16 kcals/kg/day to 39 kcals/kg/day. The mean REE (888±176 kcals/day) of the patients was significantly (p<0.01) lower than predicted as estimated by the Harris-Benedict equations (1081±155 kcals/day) and World Health Organization equations (1194±167 kcals/day). Fat-free mass (FFM) was the best parameter for predicting REE. Two predictive equations were developed that are not significantly biased and more precise (≤15% error) than conventional predictive formulas. Conclusion: Conventional formulas for estimating energy expenditure are inaccurate and generally overestimate measured energy expenditure of nonambulatory patients with severe developmental disabilities. © 1999 American College of Nutrition.