Oral Presentation ANZBA Annual Scientific Meeting 2024

Concurrent validity of clinical equations to predict resting energy expenditure compared to indirect calorimetry in non-severe burn patients (#5a)

Tyler Osborne 1 2 , TImothy Fairchild 1 3 , Dale W Edgar 2 4 5 6 , Brook Galna 1 3 7 , Fiona Wood 2 5 6 , Brodie Allan 1 , Thomas Le Huray 1 , Brad Wall 1 3
  1. School of Allied Health (Exercise Science), Murdoch University, Perth, Western Australia, Australia
  2. Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
  3. Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Perth, Western Australia
  4. Burn Injury Research Node, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
  5. State Adult Burns Unit, South Metropolitan Health Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
  6. Burn Injury Research Unit, University of Western Australia, Crawley, Western Australia, Australia
  7. Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia

Both underfeeding or overfeeding can inhibit recovery and negatively impact quality of life during and after receiving treatment for a burn injury. Clinicians rely on accurate estimation of resting energy expenditure to avoid overfeeding or underfeeding their patients. The gold standard for measuring resting energy expenditure is indirect calorimetry. Burn services commonly use predictive equations to prescribe feeding regimes because they are less expensive, time efficient and logistically more expedient than indirect calorimetry and do not require specialised equipment. However, the validity of these clinical equations has not been established in non-severe burn patients (<15% total burn surface area, TBSA). In this study, resting energy expenditure was measured for 35 participants with non-severe burn injuries using indirect calorimetry at day 4 (± 1 day) post-burn.  The measured REE was then compared to that calculated using seven established clinical equations.. We found poor agreement between the clinical equations and indirect calorimetry in predicting resting energy expenditure, with the Schofield equation agreeing most closely (95% limits of agreement: -836 to 711 kcal.day-1). Agreement between clinical equations and indirect calorimetry remained poor even after correcting for TBSA. Our study is the first to examine the validity of a range of predictive equations in comparison to indirect calorimetry, and our findings indicate clinical equations may not accurately predict resting energy expenditure of people who have sustained a non-severe burn. As such, we urge caution against relying solely on the existing predictive equations to guide clinical decisions regarding energy intake after non-severe burns.