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  • Assessment
    In healthy adults, how long of a rest period is needed prior to initiating an RMR measure?
    • Conclusion

      A minimum rest period length of 10-20 minutes is an adequate testing condition to obtain an accurate measure of a 24-hour resting metabolic rate in healthy adults that have traveled to the test measurement site.

    • 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.
    In ill or hospitalized, adult patients, how long of a rest period is needed prior to initiating an RMR measure?
    • Conclusion

      One study of neutral quality rating (Swinamer, 1987) representing 10 critically ill individuals (27-79 y) with APACHE II score of 12-34, and a sepsis score of 0-23 indicates that during the first 30 minutes after patient activities (such as patient weighing, repositioning, and chest physiotherapy), a group mean RMR increase of 5.8±4.3% occurred. Shorter times were not reported. Two narrative reviews are most frequently cited for identifying rest period lengths provide the foundation for the currently accepted 30-minute rest length for adult patients in critical illness settings.

      Consensus of expert panel members recommend further research to determine if RMR measures following shorter rest periods (i.e., 5, 10, or 15 minutes) are statistically or clinically significant than RMR measures following a 30 minute rest period in all types of ill adults in the acute care settings.

       

    • Grade: IV
      • 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.
    In stable, acute care adult patients, what are the energy measurement differences if rest period lengths vary before measuring energy expenditure?
    • Conclusion

      An international study of negative research quality design (Schols, 1992) indicates individual RMR differences between a measurements performed on 12 older adult COPD patients after awakening, being transported in a wheelchair to the measurement site and allowing a 7-minute acclimatization period compared to a RMR measure taken after light physical activities and allowing a 20-minute rest were les than 70 kcals/day.

    • Grade: V
      • 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.