• Assessment
    In critical care adults, what are the group mean energy measurement differences between measurements performed on the same individual at various times of the day, assuming resting conditions are followed?
    • Conclusion

      A study of high quality research design reported group mean RMR at 0700 or 1900 was within 5% of the 12-hour period prior to the RMR measures (i.e., referenced as total energy expenditure) in 33 (13 trauma and 20 septic) that were mechanically-ventilated, sedated, sometimes medically paralyzed, multiple organ dysfunction patients receiving continuous TPN patients (86 paired measures in trauma patients; and 154 paired measures in septic). Total energy expenditure measured over the night hours (19 00 to 07 00 hr) was not significantly different from total energy expenditure measured over the day hours (07 00 to 19 00 h) in trauma and septic patients (p>0.05). Another study of neutral quality research design reports <3% group mean RMR deviation in eight, 3-hour intervals (i.e., 24-hours) in 50 post-surgical ICU patients with ventilation. 

    • 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.