The Metabolic Cart in Critical Care: How to measure resting energy expenditure (REE) and apply this to your patient.
This forty minute video is a good introduction to using a metabolic cart in the intensive care unit.
The first 15 minutes of this video looks at some of the technical issues of measuring REE in the intensive care.
The second 15minutes demonstrates taking a measurement in a patient and finally the last 15 minutes demonstrates several clinical cases from real critical care patients.
Predictive equations may both underestimate and overestimate the resting energy expenditure (REE) of patients in the ICU.
While some patients with adequate nutritional reserves may withstand periods of fasting and starvation, other patients who are nutritionally threatened will not survive a rapidly growing energy deficit.
To better understand the nutritional needs of critically ill patients we must first measure REE and then use this data in the clinical context at the bedside. Metabolic carts can measure oxygen Consumption VO2, and Carbon Dioxide production VCO2. This can then be used to calculate the Respiratory Quotient RQ and secondarily using the modified Weir Equation the Resting Energy Expenditure(REE) can be calculated. In this workshop we demonstrate how a metabolic cart works and then discuss some clinical cases with surprising results.
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