Nutrition support is important in the care of patients with both acute and chronic illness. Optimizing nutritional support for the critically ill and patients with acute and chronic respiratory disorders has been shown to shorten length of stay, shorten duration of mechanical ventilation, lower health-care costs and reduce morbidity and mortality while improving functional quality of life. Nutritional requirements are difficult to predict in patients diagnosed with cancer due to their disease processes, altered inflammatory responses and metabolic rates among many other variables. Often predictive equations are used to estimate energy requirements and the average dietary energy intake needed to maintain energy balance. Energy requirements can be estimated through the use of over 200 predictive equations. Utilization of indirect calorimetry as the ‘gold standard’ for measuring resting metabolic rate (RMR) and resting energy expenditure (REE) can provide support in all states of health and disease. This chapter will identify and discuss the role of indirect calorimetry, examine the reasons why indirect calorimetry is more reliable than predictive equations in determining a patient’s calorie requirement, and when it is most applicable to incorporate indirect calorimetry measurements in the care of cancer patients.
Part of the book: Oncology Critical Care