Evaluation of a non-invasive multisensor accelerometer for calculating energy expenditure in ventilated intensive care patients compared to indirect calorimetry and predictive equations
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Continuous measurement of resting energy expenditure (REE) in critically ill patients remains challenging but is required to prevent malnutrition. SenseWear Pro 3 Armband (SWA) is a research grade accelerometer for assessment of REE with the advantage of easy handling. In a prospective study we compared SWA with indirect calorimetry (IC) and predictive equations in critically ill, ventilated patients. REE was measured by SWA, IC and calculated by predictive formulas. Potential confounding factors that influence REE were also recorded. Results of SenseWear Armband and indirect calorimetry were compared using the Bland–Altman method. 34 ICU patients were investigated. SWA underestimated resting energy expenditure compared to IC with a mean bias of ΔREE = −253.6 ± 333.2 kcal, equivalent to −11.7 % (p = 0.025). This underestimation was seen in both, medical (−14.9 %) and surgical (−12.9 %) patients and the bias was greater in patients with fever (−19.0 %), tachycardia (−18.7 %) or tachypnea (−26.2 %). Differences were also noted when SWA was compared to predictive formulas. At present, SWA cannot be regarded as an alternative to indirect calorimetry. Individual measurements are often inaccurate and should be used with caution until improved algorithms, based on the results of this study, have been implemented.
KeywordsCritically ill Indirect calorimetry Energy expenditure SenseWear Pro Armband Predictive equations
Intensive care unit
Resting energy expenditure
SenseWear Pro 3 Armband
JK, SG and LJV received a Gerhard-Domagk-Scholarship from University Medicine Greifswald made possible through unrestricted educational grants from Nutricia GmbH (Erlangen, Germany), Baxter Deutschland GmbH (Unterschleissheim, Germany) and Gesundheits GmbH (Ahrensburg).
JK and MK are equal contributors. JK, MK, MML and AAA concepted and designed the study and wrote the manuscript. All authors substantially contributed to conception, design, acquisition and analysis of data and interpretation of the study.
Compliance with ethical standards
Conflict of interest
The authors declare to have no conflict of interest.
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