Table

Energy Expenditure Equations for Critically Ill or Injured Individuals

Ireton-Jones Equations3

Ventilator Dependent:

IJEE(v) = 1784 - 11(A) + 5(W) + 244(G) + 239(T) + 804(B)

Spontaneously Breathing:

where

IJEE = kcal/day

T = trauma

No additional factor is added for activity or injury.

Kcal/Kgb

25 kcal/kg using usual or current body weight

Mifflinc

where

H = height (cm) W = actual weight (kg) A = age (years)

Use with stress factors: Mild: RMR x 1 Moderate: RMR x 1.2 - 1.3 Moderate: RMR x 1.2 - 1.3 Severe: RMR x 1.4 - 1.5

aFrom Ireton-Jones C, Jones J. Improved equations for estimating energy expenditure in patients: the

Ireton-Jones equations. Nutr. in Clin. Prac., 17 (4), 236-239, 2002. With permission.

bFrom McCowen KC, Friel C, Sternberg J, Chan S, Forse RA, Burke PA, Bistrian BR. Hypocaloric total parenteral nutrition: effectiveness in prevention of hyperglycemia and infectious complications —

a randomized clinical trial. Crit. Care Med., 28 (11), 3606-3611, 2000. With permission.

cFrom Mifflin MD, St. Jeor ST, Hill LA, et al. A new predictive equation for resting energy expenditure in healthy individuals. Am. J. Clin. Nutr., 51, 241-247, 1990. With permission.

recommended for consideration, and these are listed in Table 2.2. It is important to note that for obese patients, the actual body weight is used in these energy equations. For morbidly obese patients, there are many challenges to the care of the patient, including mobility. Maximization of nutrients with a concomitant decrease in energy (calories) may be useful to meet health goals. A qualified dietitian should always be involved in the management of a patient with wounds, especially those who are obese.

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