Energy Expenditure

EE: Respiratory Quotient (RQ) (2013)

• Assessment
  What is the accuracy of respiratory quotient (RQ) to detect resting metabolic rate (RMR) measurement error in the critically ill population?

  • Conclusion

    Limited research reports that respiratory quotient (RQ) is affected by ventilator resetting and may remain within the physiologic range without altering the resting metabolic rate (RMR) measurement in the critically ill population. Additional research is needed regarding the accuracy of RQ to detect RMR measurement error in the critically ill population.

  • 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: What is the accuracy of respiratory quotient (RQ) to detect resting metabolic rate (RMR) measurement error in the critically ill population?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Brandi LS, Bertolini R, Santini L, Cavani S. Effects of ventilator resetting on indirect calorimetry measurement in the critically ill surgical patient. Crit Care Med. 1999;27(3):531-539.
  • Search Plan and Results: EE: Respiratory Quotient in Critically Ill Individuals 2012
     
  What is the accuracy of respiratory quotient (RQ) to evaluate feeding level in the critically ill population?

  • Conclusion

    Research reports that respiratory quotient (RQ) has poor accuracy to evaluate under- and overfeeding. RQ can vary among individuals at any given feeding level and can be altered by factors unrelated to feeding.

     

  • 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: What is the accuracy of respiratory quotient (RQ) to evaluate feeding level in the critically ill population?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Brandi LS, Bertolini R, Santini L, Cavani S. Effects of ventilator resetting on indirect calorimetry measurement in the critically ill surgical patient. Crit Care Med. 1999;27(3):531-539.
      • Frankenfield DC, Smith JS, Cooney RN. Accelerated nitrogen loss after traumatic injury is not attenuated by achievement of energy balance. J Parent Enteral Nutr. 1997; 21(6): 324-329.
      • Guenst IM, Nelson LD. Predictors of parenteral nutrition-induced lipogenesis. Chest. 1994;105(2):553-559.
      • Ireton-Jones CS, Turner WW. The use of respiratory quotient to determine the efficacy of nutrition support regimes. J Am Diet Assoc. 1987 (2): 180-183.
      • McClave SA, Lowen CC, Kleber MJ, CmConnell , Jung LY, Goldsmith LJ. Clinical use of the respiratory quotient obtained from indirect calorimetery. J Parenter Enteral Nutr. 2003;27(1):21-26.
      • Weissman C, Kemper M, Askanazi J, Hyman AI, Kinney JM. Resting metabolic rate of the critically ill patients: Measured versus predicted. J Anesthesiology. 1986;64(6):673-679.
      • Zauner C, Schuster BI, Schneeweiss B. Similar metabolic responses to standardized total parenteral nutrition of septic and nonseptic critcally ill patients. Am J Clin Nutr. 2001;74:265-270
  • Search Plan and Results: EE: Respiratory Quotient in Critically Ill Individuals 2012