J Neurointensive Care.
2023 Apr;6(1):1-8. 10.32587/jnic.2023.00626.
Clinical Application and Significance of Indirect Calorimetry in Neurocritical Care
- Affiliations
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- 1Department of Neurological Surgery and Critical Care Medicine, Seoul St. Mary’s Hospital, Catholic University of Korea, Seoul, Korea
- 2Department of Neurological Surgery and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 3Department of Neurological Surgery and Critical Care Medicine, Chungnam National University Hospital, Daejeon, Korea
- 4Department of Neurological Surgery and Critical Care Medicine, Seoul National University Hospital, Seoul, Korea
- 5Department of Neurological Surgery and Critical Care Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- 6Department of Neurological Surgery and Critical Care Medicine, Kangbuk Samsung Hospital, Seoul, Korea
- 7Department of Neurological Surgery and Critical Care Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
- 8Department of Neurological Surgery and Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- 9Department of Neurological Surgery and Critical Care Medicine, Yeungnam University Medical Center, Daegu, Korea
- 10Department of Neurological Surgery and Critical Care Medicine, Gachon University Gil Hospital Regional Trauma Center, Incheon, Korea
- 11Department of Neurological Surgery and Critical Care Medicine, Gangnam Severance Hospital, Seoul, Korea
- 12Department of Neurological Surgery and Critical Care Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea
- KMID: 2555074
- DOI: http://doi.org/10.32587/jnic.2023.00626
Abstract
- Neurocritical care has emerged as a specialized field addressing the complex needs of patients with acute neurological disorders, such as stroke, brain tumor and traumatic brain injury. The clinical management of these patients necessitates precise, individualized nutritional support due to the significant variability in neurological deficits and resting energy expenditure (REE) based on factors including stroke phase, type (hemorrhagic or ischemic), and intracranial pressure and activity of neuronal cells. This emphasizes the need for accurate, patient-specific nutritional recommendations, achievable through indirect calorimetry. Traditional predictive equations may not accurately capture the diverse nutritional requirements of neurocritical patients. Indirect calorimetry offers a more reliable, personalized approach to determining patients' nutritional needs, crucial for this heterogeneous population. Furthermore, clinical practice often inadequately addresses nutritional needs in neurocritical patients, highlighting the importance of optimizing nutritional support to enhance patient outcomes. Indirect calorimetry also plays a critical role in assessing patients with non-normal body temperatures. Hypothermia affects the body's metabolic rate and overall energy expenditure, making it challenging to evaluate energy requirements during hypothermia treatment. Indirect calorimetry can provide more accurate assessments under such conditions. In conclusion, employing indirect calorimetry in neurocritical care is essential for accurate, individualized nutritional support. By accounting for factors such as stroke type, location, intracranial pressure and body temperature, indirect calorimetry offers valuable insights and improved patient care, emphasizing its indispensability in managing neurocritical patients.
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