Chen J, See KC. Energy expenditure measurement in critical care: Implications for personalized nutrition support. World J Crit Care Med 2025; 14(3): 105299 [DOI: 10.5492/wjccm.v14.i3.105299]
Corresponding Author of This Article
Jiayang Chen, Department of Medicine, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Singapore 119228, Singapore. jiayang_chen1997@live.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Sep 9, 2025; 14(3): 105299 Published online Sep 9, 2025. doi: 10.5492/wjccm.v14.i3.105299
Energy expenditure measurement in critical care: Implications for personalized nutrition support
Jiayang Chen, Kay Choong See
Jiayang Chen, Kay Choong See, Department of Medicine, National University Hospital, Singapore 119228, Singapore
Author contributions: Jiayang C and See KC were involved in the screening, selection and data extraction of included studies, as well as the writing and editing of the final manuscript.
Conflict-of-interest statement: Authors have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jiayang Chen, Department of Medicine, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Singapore 119228, Singapore. jiayang_chen1997@live.com
Received: January 18, 2025 Revised: March 5, 2025 Accepted: April 18, 2025 Published online: September 9, 2025 Processing time: 182 Days and 11.2 Hours
Abstract
BACKGROUND
Accurate measurement of energy expenditure (EE) is critical for optimizing nutritional support in critically ill patients. Indirect calorimetry (IC) is the reference method used, but its availability at the bedside is limited. As a result, numerous predictive equations have been devised to estimate EE in critically ill patients, along with other more novel methods recently proposed.
AIM
To evaluate current methods of measuring EE in critical care, focusing on practical challenges, accuracy, feasibility, and limitations. We will also discuss how these methods contribute to improving nutrition support strategies for intensive care unit patients for a more personalised and effective solution.
METHODS
A comprehensive search was conducted in PubMed and EMBASE for studies published from December 2014 to December 2024. Eligible studies compared EE measurement methods in critically ill populations. Data extraction and quality assessment followed PRISMA guidelines. Adherence to reporting standards was assessed using the TRIPOD questionnaire and risk of bias was evaluated using the PROBAST tool.
RESULTS
Twenty five original studies met the inclusion criteria and were analysed.
CONCLUSION
Each method has unique strengths and limitations. We found that while IC remains the reference standard, less accurate predictive equations have greater accessibility and ease of implementation. Emerging technologies show promise for bedside applicability. Future research should address practical barriers and validate newer approaches.
Core Tip: This systematic review evaluates current methods of measuring energy expenditure in critical care, focusing on practical challenges, accuracy, feasibility, and limitations of each one. We find that indirect calorimetry (IC) remains the gold standard with the most accurate measurements, but there remains significant difficulty in widespread use. Predictive equations are more accessible but lack accuracy. However, there are new ways of using IC and predictive equations that bring promise, and new alternative methods also show potential for application in the clinical context.
