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Correction to: Substrate utilization and energy expenditure pattern in sepsis by indirect calorimetry

The Original Article was published on 31 August 2020

Correction to: Critical Care (2020) 24:535 https://doi.org/10.1186/s13054-020-03245-2

Following publication of the original article [1], the authors reported a misalignment error of the x-axis in Fig. 1b; in addition, there were two typos and two formatting errors. The revised Fig. 1b and revised text is indicated hereafter. The changes have been highlighted in bold typeface.

Fig. 1
figure 1

a Difference between calculated and measured energy expenditure over time. b Percentage of patients in RQ groups (≤ 0.8 vs. > 0.8) between survivors and non-survivors


The sentence currently reads:


The metabolic profiles differed between survivors and non-survivors (Fig. 1a). Both groups had negative energy balance during fasting state. Survivors transitioned to a hypermetabolic state following feeding initiation, achieving positive energy balance. Non-survivors remained hypometabolic despite feeding.


The sentence should read:


The metabolic profiles differed between survivors and non-survivors (Fig. 1a). Both groups had negative energy balance during fasting state. Survivors transitioned to a hypermetabolic state following feeding initiation, achieving positive energy balance. Non-survivors remained hypometabolic despite feeding.


The sentence currently reads:


Our study advances the understanding of energy balance and substrate utilization in sepsis. During fasting, low insulin with elevated counter-regulatory hormones promotes lipolysis; muscle glycogen is depleted at an exponential rate greater than athletes running marathons [4]. The predominant energy substrate switches from carbohydrates to lipids—the hallmark of fasting physiology. This explains the low RQ in early sepsis, when patients are preferentially utilizing lipids (RQ ≤ 0.8) during permissive underfeeding [5]. The hypermetabolic state and inability for non-survivors to transit to carbohydrate utilization suggest ongoing debilitating mitochondrial dysfunction, consistent with associated multi-organ failure [6]. However, whether adjusting the feeding types and regimen to alter these patterns and improve outcomes remain unknown.


The sentence should read:


Our study advances the understanding of energy balance and substrate utilization in sepsis. During fasting, low insulin with elevated counter-regulatory hormones promotes lipolysis; muscle glycogen is depleted at an exponential rate greater than athletes running marathons [4]. The predominant energy substrate switches from carbohydrates to lipids—the hallmark of fasting physiology. This explains the low RQ in early sepsis, when patients are preferentially utilizing lipids (RQ ≤ 0.8) during relative underfeeding [5]. The hypometabolic state and inability for non-survivors to transit to carbohydrate utilization suggest on-going debilitating mitochondrial dysfunction, consistent with associated multi-organ failure [6]. However, whether adjusting the feeding types and regimen to alter these patterns to improve outcomes remain unknown.

This has now been included in this correction article.

References

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  2. Wischmeyer PE, San-Millan I. Winning the war against ICU-acquired weakness: new innovations in nutrition and exercise physiology. Crit Care. 2015;19(Suppl 3):S6.

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  3. Arabi YM, Aldawood AS, Haddad SH, Al-Dorzi HM, Tamim HM, Jones G, et al. Permissive underfeeding or standard enteral feeding in critically ill adults. N Engl J Med. 2015;372:2398–408.

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Correspondence to Andrew Li.

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Li, A., Mukhopadhyay, A. Correction to: Substrate utilization and energy expenditure pattern in sepsis by indirect calorimetry. Crit Care 24, 660 (2020). https://doi.org/10.1186/s13054-020-03391-7

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  • DOI: https://doi.org/10.1186/s13054-020-03391-7