The clinical evaluation of the new indirect calorimeter developed by the ICALIC project

Taku Oshima; Marta Delsoglio; Yves M Dupertuis; Pierre Singer; Elisabeth De Waele; Cecilia Veraar; Claudia-Paula Heidegger; Jan Wernermann; Paul E Wischmeyer; Mette M Berger; Claude Pichard

doi:10.1016/j.clnu.2020.01.017

The clinical evaluation of the new indirect calorimeter developed by the ICALIC project

Clin Nutr. 2020 Oct;39(10):3105-3111. doi: 10.1016/j.clnu.2020.01.017. Epub 2020 Jan 31.

Authors

Affiliations

¹ Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana Chuou-ku, Chiba City, Chiba, 260-8677, Japan. Electronic address: t_oshima@chiba-u.jp.
² Nutrition Unit, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva, Switzerland. Electronic address: marta.delsoglio@hcuge.ch.
³ Nutrition Unit, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva, Switzerland. Electronic address: yves.m.dupertuis@hcuge.ch.
⁴ Critical Care Medicine, Institute for Nutrition Research, Rabin Medical Center, Beilison Hospital, Petah Tikva, 49100, Israel. Electronic address: psinger@clalit.org.il.
⁵ Department of Intensive Care, Vrije Universiteit Brussel, Brussels, Belgium; Department of Intensive Care, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium; Department of Nutrition, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: Elisabeth.DeWaele@uzbrussel.be.
⁶ Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, University Hospital of Vienna, Waehrihger Guertel 18-20, 1090 Vienna, Austria. Electronic address: cecilia.veraar@meduniwien.ac.at.
⁷ Department of Acute Medicine, Division of Intensive Care, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland. Electronic address: claudia-paula.heidegger@hcuge.ch.
⁸ Department of Anesthesiology and Intensive Care Medicine, Karolinska University Hospital Huddinge, Sweden. Electronic address: jan.wernerman@karolinska.se.
⁹ Department of Anesthesiology, Duke University, Durham, NC, USA. Electronic address: paul.wischmeyer@duke.edu.
¹⁰ Service of Adult Intensive Care, Lausanne University Hospital, 1011 Lausanne, Switzerland. Electronic address: Mette.Berger@chuv.ch.
¹¹ Nutrition Unit, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva, Switzerland. Electronic address: claude.pichard@unige.ch.

PMID: 32046881
DOI: 10.1016/j.clnu.2020.01.017

Abstract

Background & aims: The ICALIC project was initiated for developing an accurate, reliable and user friendly indirect calorimeter (IC) and aimed at evaluating its ease of use and the feasibility of the EE measurements in intensive care unit (ICU).

Methods: This was a prospective unblinded, observational, multi-center study. Simultaneous IC measurements in mechanically ventilated ICU patients were performed using the new IC (Q-NRG®) and currently used devices. Time required to obtain EE was recorded to evaluate the ease of use of Q-NRG® versus currently used ICs and EE measurements were compared. Conventional descriptive statistics were used: data as mean ± SD.

Results: Six centers out of nine completed the required number of patients for the primary analysis. Mean differences in the time needed by Q-NRG® against currently used ICs were -32.3 ± 2.5 min in Geneva (vs. Deltatrac®; p < 0.01), -32.3 ± 3.1 in Lausanne (vs. Quark RMR®; p < 0.05), -33.7 ± 1.4 in Brussels (vs. V-Max Encore®; p < 0.05), -26.4 ± 7.8 in Tel Aviv (vs. Deltatrac®; p < 0.05), -28.5 ± 3.5 in Vienna (vs. Deltatrac®; p < 0.05), and 0.3 ± 1.2 in Chiba (vs. E-COVX®; p = 0.17). EE (kcal/day) measurements by the Q-NRG® were similar to the Deltatrac® in Geneva and Vienna (mean differences±SD: -63.1 ± 157.8 (p = 0.462) and -22.9 ± 328.2 (=0.650)), but significantly different in Tel Aviv (307.4 ± 324.5, p < 0.001). Significant differences were observed in Lausanne (Quark RMR®^: -224.4 ± 514.9, p = 0.038) and in Brussels (V-max®: -449.6 ± 667.4, p < 0.001), but none was found in Chiba (E-COVX®; 55.0 ± 204.1, p = 0.165).

Conclusion: The Q-NRG® required a much shorter time than most other ICs to determine EE in mechanically ventilated ICU patients. The Q-NRG® is the only commercially available IC tested against mass spectrometry to ensure gas accuracy, while being very easy-to use.

Keywords: Energy expenditure; Indirect calorimeter; Indirect calorimetry; Mechanical ventilation.

Publication types

Comparative Study
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Validation Study

MeSH terms

Adult
Aged
Aged, 80 and over
Calorimetry, Indirect / instrumentation*
Energy Metabolism*
Equipment Design
Europe
Feasibility Studies
Female
Humans
Intensive Care Units
Israel
Japan
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Respiration, Artificial