Open Access

VCO2 calorimetry: stop tossing stones, it’s time for building!

  • Elisabeth De Waele1Email author,
  • Patrick M. Honoré1 and
  • Herbert D. Spapen1
Critical Care201620:399

https://doi.org/10.1186/s13054-016-1575-z

Published: 16 December 2016

The original article was published in Critical Care 2015 19:370

Keywords

Energy expenditureNutritionIntensive care unit

We followed with interest the discussion [1, 2] fueled by the study of Stapel et al. [3] who reported fairly accurate assessment of energy expenditure (EE) in critically ill patients based on ventilator-derived carbon dioxide production (VCO2). The proposed technique is elegant and valid but has inherent limitations. It is applicable in patients who are in one way or another ventilator-dependent but not in spontaneously breathing yet oxygen-dependent subjects. We concur that VO2 is the most relevant variable for EE measurement. However, the most accurate and precise estimation of EE in a critically ill population can only be obtained by sampling of inspired and expired oxygen/carbon dioxide concentrations and measuring expired gas flow. This is the core task of indirect calorimetry [4].

Initiative has been undertaken to develop a ‘full option’, easy-to-use, accurate, and affordable indirect calorimeter. The project is supported by the European Society of Intensive Care Medicine and the European Society of Parenteral and Enteral Nutrition [5] and has actually reached Technology Readiness Level. It is probably only a matter of time before such a device will render all current mathematical uproar obsolete.

Notes

Abbreviations

EE: 

Energy expenditure

VCO2

Carbon dioxide production

Declarations

Acknowledgements

Not applicable.

Funding

The authors declare that they have received no external funding.

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Authors’ contributions

EDW designed the paper; EDW, PMH, and HDS participated in drafting the manuscript, and have read and approved the final version.

Authors’ information

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Authors’ Affiliations

(1)
ICU Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel

References

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Copyright

© The Author(s). 2016

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