CI: Individual Equations (2010)
For more information on all predictive equations used in critically ill adults, see Predictive Equation Formulas.

Assessment
In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the Faisey equation?

Conclusion
In two studies, the Faisy equation was unbiased but inaccurate, as it predicted RMR ±10% in 53% of subjects.

Grade: III
 Grade I means there is Good/Strong evidence supporting the statement;
 Grade II is Fair;
 Grade III is Limited/Weak;
 Grade IV is Expert Opinion Only;
 Grade V is Not Assignable.
 High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
 Moderate (B) means we are moderately confident in the effect estimate;
 Low (C) means our confidence in the effect estimate is limited;
 Very Low (D) means we have very little confidence in the effect estimate.
 Ungraded means a grade is not assignable.

Evidence Summary: In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the Faisey equation?
 Detail
 Quality Rating Summary
For a summary of the Quality Rating results, click here.
 Worksheets
 Frankenfield DC, Coleman A, Alam S, Cooney R. Analysis of estimation methods for resting metabolic rate in critically ill adults. J Parenter Enteral Nutr. 2009; 33: 27.
 Savard JF. Faisy C. Lerolle N. Guerot E. Diehl JL. Fagon JY. Validation of a predictive method for an accurate assessment of resting energy expenditure in medical mechanically ventilated patients. Critical Care Medicine. 2008; 36(4): 1,1751,183.
 Detail

Search Plan and Results: CI: Determination of RMR 2009
In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the Fick equation?
Conclusion
Five studies (four positive quality and one neutral quality) studied the thermodilution technique for measuring cardiac output and calculating RMR using the Fick equation. These studies generally report a correlation between the methods, but the equation tends to be biased and imprecise, demonstrating little agreement. Accuracy of the predictive equation was not reported.

Grade: I
 Grade I means there is Good/Strong evidence supporting the statement;
 Grade II is Fair;
 Grade III is Limited/Weak;
 Grade IV is Expert Opinion Only;
 Grade V is Not Assignable.
 High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
 Moderate (B) means we are moderately confident in the effect estimate;
 Low (C) means our confidence in the effect estimate is limited;
 Very Low (D) means we have very little confidence in the effect estimate.
 Ungraded means a grade is not assignable.

Evidence Summary: In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the Fick equation?
 Detail
 Quality Rating Summary
For a summary of the Quality Rating results, click here.
 Worksheets
 Detail

Search Plan and Results: CI: Determination of RMR 2009
In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the HarrisBenedict equation (with stress and activity factors)?
Conclusion
Seventeen studies (13 positive and four neutral research quality) compared RMR and the HarrisBenedict equation (HBE) using stress and activity factors ranging from 1.1 to 1.6. The HBE may be biased or imprecise by as much as ±900kcals, depending on the factors used. Percent accuracy ranged from 15% to 51%.

Grade: I
 Grade I means there is Good/Strong evidence supporting the statement;
 Grade II is Fair;
 Grade III is Limited/Weak;
 Grade IV is Expert Opinion Only;
 Grade V is Not Assignable.
 High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
 Moderate (B) means we are moderately confident in the effect estimate;
 Low (C) means our confidence in the effect estimate is limited;
 Very Low (D) means we have very little confidence in the effect estimate.
 Ungraded means a grade is not assignable.

Evidence Summary: In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the HarrisBenedict equation (with stress and activity factors)?
 Detail
 Quality Rating Summary
For a summary of the Quality Rating results, click here.
 Worksheets
 Alexander E, Susla GM, Burstein AH, Brown DT, Ognibene FP. Retrospective evaluation of commonly used equations to predict energy expenditure in mechanically ventilated, critically ill patients. Pharmacotherapy. 2004; 24(12): 1,6591,667.
 Anderegg BA, Worrall C, Barbour E, Simpson KN, Delegge M. Comparison of resting energy expenditure prediction methods with measured resting energy expenditure in obese, hospitalized adults. J Parenter Enteral Nutr. 2009 MarApr; 33(2): 168175.
 Boullata J, Williams J, Cottrell F, Hudson L, Compher C. Accurate determination of energy needs in hospitalized patients. J Am Diet Assoc. 2007; 107: 393401.
 Casati A, Colombo S, Leggieri C, Muttini S, Capocasa T, Gallioli G. Measured versus calculated energy expenditure in pressure support ventilated ICU patients. Minerva Anestesiol. 1996; 62 (5): 165170.
 Cheng CH, Chen CH, Wong Y, Lee BJ, Kan MN, Huang YC. Measured versus estimated energy expenditure in mechanically ventilated critically ill patients. Clin Nutr. 2002; 21 (2): 165172.
 Faisy C, Guerot E, Diehl JL, Labrousse J, Fagon JY. Assessment of resting energy expenditure in mechanically ventilated patients. Am J Clin Nutr. 2003; 78: 241249.
 Frankenfield DC, Coleman A, Alam S, Cooney R. Analysis of estimation methods for resting metabolic rate in critically ill adults. J Parenter Enteral Nutr. 2009; 33: 27.
 Savard JF. Faisy C. Lerolle N. Guerot E. Diehl JL. Fagon JY. Validation of a predictive method for an accurate assessment of resting energy expenditure in medical mechanically ventilated patients. Critical Care Medicine. 2008; 36(4): 1,1751,183.
 Stucky CC, Moncure M, Hise M, Gossage CM, Northrop D. How accurate are resting energy expenditure prediction equations in obese trauma and burn patients? J Parenter Enteral Nutr. 2008 JulAug; 32(4): 420426.
 Detail

Search Plan and Results: CI: Determination of RMR 2009
In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the HarrisBenedict equation (without adjustments)?
Conclusion
Thirteen studies (eleven positivequality and two neutralquality) compared measurements of energy expenditure with the HarrisBenedict equation (HBE), with no adjustments for stress or injury. The HBE (without adjustments) generally underestimates RMR. The underestimation may be as much as 1,000kcal. Percent accuracy ranged from 26% to 35%.

Grade: I
 Grade I means there is Good/Strong evidence supporting the statement;
 Grade II is Fair;
 Grade III is Limited/Weak;
 Grade IV is Expert Opinion Only;
 Grade V is Not Assignable.
 High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
 Moderate (B) means we are moderately confident in the effect estimate;
 Low (C) means our confidence in the effect estimate is limited;
 Very Low (D) means we have very little confidence in the effect estimate.
 Ungraded means a grade is not assignable.

Evidence Summary: In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the HarrisBenedict equation (without adjustments)?
 Detail
 Quality Rating Summary
For a summary of the Quality Rating results, click here.
 Worksheets
 Alexander E, Susla GM, Burstein AH, Brown DT, Ognibene FP. Retrospective evaluation of commonly used equations to predict energy expenditure in mechanically ventilated, critically ill patients. Pharmacotherapy. 2004; 24(12): 1,6591,667.
 Cheng CH, Chen CH, Wong Y, Lee BJ, Kan MN, Huang YC. Measured versus estimated energy expenditure in mechanically ventilated critically ill patients. Clin Nutr. 2002; 21 (2): 165172.
 Faisy C, Guerot E, Diehl JL, Labrousse J, Fagon JY. Assessment of resting energy expenditure in mechanically ventilated patients. Am J Clin Nutr. 2003; 78: 241249.
 Frankenfield DC, Coleman A, Alam S, Cooney R. Analysis of estimation methods for resting metabolic rate in critically ill adults. J Parenter Enteral Nutr. 2009; 33: 27.
 Savard JF. Faisy C. Lerolle N. Guerot E. Diehl JL. Fagon JY. Validation of a predictive method for an accurate assessment of resting energy expenditure in medical mechanically ventilated patients. Critical Care Medicine. 2008; 36(4): 1,1751,183.
 Stucky CC, Moncure M, Hise M, Gossage CM, Northrop D. How accurate are resting energy expenditure prediction equations in obese trauma and burn patients? J Parenter Enteral Nutr. 2008 JulAug; 32(4): 420426.
 Detail

Search Plan and Results: CI: Determination of RMR 2009
In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by HarrisBenedict Equation with adjustments for weight?
Conclusion
Five studies compared measurements of energy expenditure with the value predicted by HarrisBenedict equation (HBE), with adjustments. The HBE with adjustment for weight generally underestimates RMR. The HBE with stress factors can under or overestimate, depending on the factor used. Mean accuracy was 55% with a range of 34% maximum underprediction to 62% maximum overprediction.

Grade: II
 Grade I means there is Good/Strong evidence supporting the statement;
 Grade II is Fair;
 Grade III is Limited/Weak;
 Grade IV is Expert Opinion Only;
 Grade V is Not Assignable.
 High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
 Moderate (B) means we are moderately confident in the effect estimate;
 Low (C) means our confidence in the effect estimate is limited;
 Very Low (D) means we have very little confidence in the effect estimate.
 Ungraded means a grade is not assignable.

Evidence Summary: In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by HarrisBenedict Equation with adjustments for weight?
 Detail
 Quality Rating Summary
For a summary of the Quality Rating results, click here.
 Worksheets
 Anderegg BA, Worrall C, Barbour E, Simpson KN, Delegge M. Comparison of resting energy expenditure prediction methods with measured resting energy expenditure in obese, hospitalized adults. J Parenter Enteral Nutr. 2009 MarApr; 33(2): 168175.
 Boullata J, Williams J, Cottrell F, Hudson L, Compher C. Accurate determination of energy needs in hospitalized patients. J Am Diet Assoc. 2007; 107: 393401.
 Frankenfield DC, Coleman A, Alam S, Cooney R. Analysis of estimation methods for resting metabolic rate in critically ill adults. J Parenter Enteral Nutr. 2009; 33: 27.
 Detail

Search Plan and Results: CI: Determination of RMR 2009
In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the IretonJones, 1992 equations?
Conclusion
Eight studies (six positive quality, two neutral quality) compared measurements of energy expenditure with REE predicted by the original equation (IretonJones, 1992 equation). Overall accuracy rate ranged from 28% to 60% for ventilatordependent patients.

Grade: II
 Grade I means there is Good/Strong evidence supporting the statement;
 Grade II is Fair;
 Grade III is Limited/Weak;
 Grade IV is Expert Opinion Only;
 Grade V is Not Assignable.
 High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
 Moderate (B) means we are moderately confident in the effect estimate;
 Low (C) means our confidence in the effect estimate is limited;
 Very Low (D) means we have very little confidence in the effect estimate.
 Ungraded means a grade is not assignable.

Evidence Summary: In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the IretonJones, 1992 equations?
 Detail
 Quality Rating Summary
For a summary of the Quality Rating results, click here.
 Worksheets
 Cheng CH, Chen CH, Wong Y, Lee BJ, Kan MN, Huang YC. Measured versus estimated energy expenditure in mechanically ventilated critically ill patients. Clin Nutr. 2002; 21 (2): 165172.
 Frankenfield DC, Coleman A, Alam S, Cooney R. Analysis of estimation methods for resting metabolic rate in critically ill adults. J Parenter Enteral Nutr. 2009; 33: 27.
 Savard JF. Faisy C. Lerolle N. Guerot E. Diehl JL. Fagon JY. Validation of a predictive method for an accurate assessment of resting energy expenditure in medical mechanically ventilated patients. Critical Care Medicine. 2008; 36(4): 1,1751,183.
 Detail

Search Plan and Results: CI: Determination of RMR 2009
In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the IretonJones, 1997 equations?
Conclusion
Four studies (three positive quality and one neutral quality) compared measured energy expenditure with energy expenditure predicted by the IretonJones, 1997 equations, for ventilatordependent individuals. Accuracy range was 15% to 48%.

Grade: I
 Grade I means there is Good/Strong evidence supporting the statement;
 Grade II is Fair;
 Grade III is Limited/Weak;
 Grade IV is Expert Opinion Only;
 Grade V is Not Assignable.
 High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
 Moderate (B) means we are moderately confident in the effect estimate;
 Low (C) means our confidence in the effect estimate is limited;
 Very Low (D) means we have very little confidence in the effect estimate.
 Ungraded means a grade is not assignable.

Evidence Summary: In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the IretonJones, 1997 equations?
 Detail
 Quality Rating Summary
For a summary of the Quality Rating results, click here.
 Worksheets
 Alexander E, Susla GM, Burstein AH, Brown DT, Ognibene FP. Retrospective evaluation of commonly used equations to predict energy expenditure in mechanically ventilated, critically ill patients. Pharmacotherapy. 2004; 24(12): 1,6591,667.
 Anderegg BA, Worrall C, Barbour E, Simpson KN, Delegge M. Comparison of resting energy expenditure prediction methods with measured resting energy expenditure in obese, hospitalized adults. J Parenter Enteral Nutr. 2009 MarApr; 33(2): 168175.
 Detail

Search Plan and Results: CI: Determination of RMR 2009
In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the MifflinSt. Jeor equation?
Conclusion
Three positive quality research studies were reviewed. The MSJE was biased unless multiplied by a factor of 1.25, which also increased accuracy from 10% to almost 50% overall.

Grade: III
 Grade I means there is Good/Strong evidence supporting the statement;
 Grade II is Fair;
 Grade III is Limited/Weak;
 Grade IV is Expert Opinion Only;
 Grade V is Not Assignable.
 High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
 Moderate (B) means we are moderately confident in the effect estimate;
 Low (C) means our confidence in the effect estimate is limited;
 Very Low (D) means we have very little confidence in the effect estimate.
 Ungraded means a grade is not assignable.

Evidence Summary: In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the MifflinSt. Jeor equation?
 Detail
 Quality Rating Summary
For a summary of the Quality Rating results, click here.
 Worksheets
 Anderegg BA, Worrall C, Barbour E, Simpson KN, Delegge M. Comparison of resting energy expenditure prediction methods with measured resting energy expenditure in obese, hospitalized adults. J Parenter Enteral Nutr. 2009 MarApr; 33(2): 168175.
 Frankenfield DC, Coleman A, Alam S, Cooney R. Analysis of estimation methods for resting metabolic rate in critically ill adults. J Parenter Enteral Nutr. 2009; 33: 27.
 Detail

Search Plan and Results: CI: Determination of RMR 2009
In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the Penn State equations?
Conclusion
Five positive quality studies compared measured resting metabolic rate (RMR) with RMR predicted by one of the Penn State equations. The versions from 1998 and 2003 (PSU(1998), PSU(2003a)] were unbiased and precise, but some of them had accuracy rates as low as 40% and as high as 70%. In large validation studies from 2009 and 2010 the PSU(2003b) and PSU(2010) forms of the equation were accurate 70 and 74% of the time.

Grade: II
 Grade I means there is Good/Strong evidence supporting the statement;
 Grade II is Fair;
 Grade III is Limited/Weak;
 Grade IV is Expert Opinion Only;
 Grade V is Not Assignable.
 High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
 Moderate (B) means we are moderately confident in the effect estimate;
 Low (C) means our confidence in the effect estimate is limited;
 Very Low (D) means we have very little confidence in the effect estimate.
 Ungraded means a grade is not assignable.

Evidence Summary: In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the Penn State equations?
 Detail
 Quality Rating Summary
For a summary of the Quality Rating results, click here.
 Worksheets
 Boullata J, Williams J, Cottrell F, Hudson L, Compher C. Accurate determination of energy needs in hospitalized patients. J Am Diet Assoc. 2007; 107: 393401.
 Frankenfield David. Validation of an equation for resting metabolic rate in older obese critically ill patients. JPEN. 2010 (in press).
 Frankenfield DC, Coleman A, Alam S, Cooney R. Analysis of estimation methods for resting metabolic rate in critically ill adults. J Parenter Enteral Nutr. 2009; 33: 27.
 Detail

Search Plan and Results: CI: Determination of RMR 2009
In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the Swinamer equation?
Conclusion
Four studies compared RMR and the Swinamer equation. Accuracy rates ranged from 45% to 61%; however, the equation was biased toward overprediction.

Grade: I
 Grade I means there is Good/Strong evidence supporting the statement;
 Grade II is Fair;
 Grade III is Limited/Weak;
 Grade IV is Expert Opinion Only;
 Grade V is Not Assignable.
 High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
 Moderate (B) means we are moderately confident in the effect estimate;
 Low (C) means our confidence in the effect estimate is limited;
 Very Low (D) means we have very little confidence in the effect estimate.
 Ungraded means a grade is not assignable.

Evidence Summary: In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the Swinamer equation?
 Detail
 Quality Rating Summary
For a summary of the Quality Rating results, click here.
 Worksheets
 Boullata J, Williams J, Cottrell F, Hudson L, Compher C. Accurate determination of energy needs in hospitalized patients. J Am Diet Assoc. 2007; 107: 393401.
 Frankenfield DC, Coleman A, Alam S, Cooney R. Analysis of estimation methods for resting metabolic rate in critically ill adults. J Parenter Enteral Nutr. 2009; 33: 27.
 Savard JF. Faisy C. Lerolle N. Guerot E. Diehl JL. Fagon JY. Validation of a predictive method for an accurate assessment of resting energy expenditure in medical mechanically ventilated patients. Critical Care Medicine. 2008; 36(4): 1,1751,183.
 Detail

Search Plan and Results: CI: Determination of RMR 2009
In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the Brandi equation?
Conclusion
One positive research quality study was reviewed for this evidence analysis question. The Brandi equation was unbiased toward nonobese patients with accuracy of 61%. It was biased for obese patients with accuracy of 48%.

Grade: III
 Grade I means there is Good/Strong evidence supporting the statement;
 Grade II is Fair;
 Grade III is Limited/Weak;
 Grade IV is Expert Opinion Only;
 Grade V is Not Assignable.
 High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
 Moderate (B) means we are moderately confident in the effect estimate;
 Low (C) means our confidence in the effect estimate is limited;
 Very Low (D) means we have very little confidence in the effect estimate.
 Ungraded means a grade is not assignable.
 Evidence Summary: In adult critically ill patients, what is the relationship between resting metabolic rate (RMR) and RMR predicted by the Brandi equation?

Search Plan and Results: CI: Determination of RMR 2009

Conclusion