Predicting Resting Energy Expenditure in Critically Ill Patients by Measuring Lean Body Mass by US

NCT03193632 | Completed

• 1 other identifier: LBM_REE
• Study Type: observational
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

The study aims to correlate Lean Body Mass (LBM) Evaluated by Musculoskeletal Ultrasound with Resting Energy Expenditure (REE) measured by Indirect Calorimetry and to generate a predictive equation of REE based on LBM, in addition to identifying other factors that may affect REE such as age, gender, and severity scores.

Conditions

Resting Energy Expenditure

Keywords

lean body mass; resting energy expenditure; oxygen consumption; Indirect calorimetry; carbon dioxide excretion; respiratory quotient

Outcome Measures

Primary Outcomes (1)

• correlation between LBM derived from ultrasound MLT and REE by indirect calorimetry

  The correlation of the LBM derived from ultrasound MLT to the REE measured within 24 hours of ICU admission with indirect calorimetry

  24 hours of ICU admission

Secondary Outcomes (2)

• Predictive equation for REE based on US measurement of MLT

  24 hours of ICU admission

• Estimation of the effect of severity scores on the REE

  24 hours of ICU admission

Study Arms (1)

Study group

critically-ill patients who will be admitted to the surgical ICU for ventilatory support and will be expected to continue for more than one day US Muscle layer thickness (MLT) estimation will be used to estimate LBM and REE estimation by indirect calorimetry will be performed

Diagnostic Test: US Muscle layer thickness (MLT) estimation; Diagnostic Test: REE estimation by indirect calorimetry

Interventions

US Muscle layer thickness (MLT) estimation DIAGNOSTIC_TEST

Three measurements will be made at each of three sites; mid-upper arm, forearm and thigh anteriorly and the mean value will be calculated. Measurement sites will be marked with indelible ink to ensure day-to-day consistency. 1. Thigh: MLT of the quadriceps femoris muscle (M. Vastus intermedius and M. rectus femoris) will be assessed bilaterally 2. Mid-upper arm: Muscle layer thickness will be measured over the biceps,midway between the tip of the acromion and the tip of the olecranon 3. Forearm: A point midway between the antecubital skin crease and the ulnar styloid was marked and muscle thickness down to the interosseus membrane

Study group

REE estimation by indirect calorimetry DIAGNOSTIC_TEST

REE will be calculated using indirect calorimetry via metabolic module on General Electric ventilator (Engstrom Carestation and Carescape R860, GE Health care, USA) All indirect calorimetric measurements will be done using standardized technique. Gas calibration will be performed before each measurement, and the measurements will last for at least 30 minutes. Measurements will be taken with the patient lying supine and ventilator settings left unchanged for at least 60 minutes ahead of indirect calorimetry. The REE will be calculated during the first 24 hours of admission to ICU.

Study group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

critically-ill patients who will be admitted to the surgical ICU for ventilatory support and will be expected to continue more than one day

You may qualify if:

• \- Patient requiring ventilatory support \> 24 hours

You may not qualify if:

• Patient who will require FIO2 more than 0.6.
• Air leak from the chest tube.
• Patient with body temperature \> 39oC.
• Patients with known endocrine dysfunction.
• Patients on parenteral nutrition

Sponsors & Collaborators

• Eslam Ayman Mohamed Shawki: lead

Study Sites (1)

Faculty of medicine, Cairo University teaching hospitals (Kasr Alainy)

Cairo, Egypt

Location

Related Publications (9)

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  PMID: 14758147 BACKGROUND

• Covelli HD, Black JW, Olsen MS, Beekman JF. Respiratory failure precipitated by high carbohydrate loads. Ann Intern Med. 1981 Nov;95(5):579-81. doi: 10.7326/0003-4819-95-5-579.

  PMID: 6794409 BACKGROUND

• Walker RN, Heuberger RA. Predictive equations for energy needs for the critically ill. Respir Care. 2009 Apr;54(4):509-21.

  PMID: 19327188 BACKGROUND

• Fung EB. Estimating energy expenditure in critically ill adults and children. AACN Clin Issues. 2000 Nov;11(4):480-97. doi: 10.1097/00044067-200011000-00002.

  PMID: 11288413 BACKGROUND

• Campbell IT, Watt T, Withers D, England R, Sukumar S, Keegan MA, Faragher B, Martin DF. Muscle thickness, measured with ultrasound, may be an indicator of lean tissue wasting in multiple organ failure in the presence of edema. Am J Clin Nutr. 1995 Sep;62(3):533-9. doi: 10.1093/ajcn/62.3.533.

  PMID: 7661114 BACKGROUND

• Sanada K, Kearns CF, Midorikawa T, Abe T. Prediction and validation of total and regional skeletal muscle mass by ultrasound in Japanese adults. Eur J Appl Physiol. 2006 Jan;96(1):24-31. doi: 10.1007/s00421-005-0061-0. Epub 2005 Oct 19.

  PMID: 16235068 BACKGROUND

• Pineau JC, Guihard-Costa AM, Bocquet M. Validation of ultrasound techniques applied to body fat measurement. A comparison between ultrasound techniques, air displacement plethysmography and bioelectrical impedance vs. dual-energy X-ray absorptiometry. Ann Nutr Metab. 2007;51(5):421-7. doi: 10.1159/000111161. Epub 2007 Nov 20.

  PMID: 18025814 BACKGROUND

• Ely EW, Truman B, Shintani A, Thomason JW, Wheeler AP, Gordon S, Francis J, Speroff T, Gautam S, Margolin R, Sessler CN, Dittus RS, Bernard GR. Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA. 2003 Jun 11;289(22):2983-91. doi: 10.1001/jama.289.22.2983.

  PMID: 12799407 BACKGROUND

• Muller MJ, Illner K, Bosy-Westphal A, Brinkmann G, Heller M. Regional lean body mass and resting energy expenditure in non-obese adults. Eur J Nutr. 2001 Jun;40(3):93-7. doi: 10.1007/s003940170008.

  PMID: 11697446 BACKGROUND

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Lecturer of anesthesia, SICU & Pain Management

Study Record Dates

• First Submitted: June 19, 2017
• First Posted: June 21, 2017
• Study Start: July 1, 2017
• Primary Completion: July 1, 2018
• Study Completion: August 1, 2018
• Last Updated: October 4, 2018

Record last verified: 2018-10

Locations

EG (1)