Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-07T08:34:43.622Z Has data issue: false hasContentIssue false
  • English
  • Français

Insights into energy requirements in disease

Published online by Cambridge University Press:  02 January 2007

Marinos Elia
Marinos Elia*
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Mailpoint 113, Tremona Road, Southampton, SO16 6YD, UK
*
*Corresponding author: Email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Accurate information about the energy needs of a range of acute and chronic diseases and morbidity is lacking and often complicated by the medication prescribed to treat the condition and also because of the presence of pre-existing malnutrition. Assessing the energy requirements of patients with acute and chronic diseases is more complex than for those in good health. These requirements not only depend on the aggressiveness of the disease and level of inactivity it causes, but also on the treatment, and the presence of prior malnutrition. It used to be generally believed that the energy requirements were increased in a number of diseases. It is now realised that this is not usually the case. Therefore, it is necessary to put these changing ideas into context by considering a wide range of acute and chronic diseases which this paper proposes to do. This paper is almost exclusively restricted to studies that have measured total energy expenditure (TEE) using tracer techniques in both hospital and the community (mostly doubly labelled water and to a lesser extent bicarbonate–urea), and continuous 24–hour indirect calorimetry in artificially ventilated patients in hospital.

Keywords

Total energy requirementsDiseaseAcuteChronicDisease related inactivity
Type
Research Article
Information
Public Health Nutrition , Volume 8 , Issue 7a , October 2005 , pp. 1037 - 1052
Copyright
Copyright © The Author 2005

References

1Macallan, DC, Noble, C, Baldwin, C, Jebb, SA, Prentice, AM, Coward, WA, Sawyer, MB, McManus, TJ, Griffin, GE. Energy expenditure and wasting in human immunodeficiency virus infection. New England Journal of Medicine 1995; 333: 83–8.CrossRefGoogle ScholarPubMed
2Paton, NIJ, Elia, M, Jebb, SA, Jennings, G, Macallan, DC, Griffin, GE. Total energy expenditure and physical activity measured with the bicarbonate-urea method in patients with human immunodeficiency virus infection. Clinical Science 1996; 91: 241–5.CrossRefGoogle ScholarPubMed
3Heijlingenberg, R, Romjin, JA, Westerterp, KR, Jonkers, CF, Prins, JM, Sauerwein, HP. Total energy expenditure in human immunodeficiency virus-infected man and healthy controls. Metabolism 1997; 46: 1324–6.CrossRefGoogle Scholar
4Selberg, O, Coors, M, Trimborn, P, Ockenga, J, Muller, MJ, Suttmann, U. Energy balance in stable human immunodeficiency virus infected patients: q doubly labelled water study. Clinical Nutrition 2000; 19(Suppl. 1): (Abs)1.Google Scholar
5Johann-Liang, R, O'Neill, L, Cervia, J, Haller, I, Giunta, Y, Licholai, T, Noel Gary, J. Energy balance, viral burden, insulin-like growth factor-1, interleukin-6 and growth impairment in children infected with human immunodeficiency virus. AIDS 2000; 14: 683–90.CrossRefGoogle ScholarPubMed
6Arpadi, SM, Cuff, PA, Kotler, DP, Wang, J, Bamji, M, Lange, M, Pierson, RN, Matthews, DE. Growth velocity, fat-free mass and energy intake are inversely related to viral load in HIV-infected children. Journal of Nutrition 2000; 130: 2498–502.CrossRefGoogle ScholarPubMed
7Bennet, N, Jarvis, L, Rowlands, O, Singleton, N, Haselden, L. Living in Britain. Results of the 1994 General Household Survey. Office of Population Censuses and Surveys, Social Survey Division, Her Majecsty's Stationery Office, London, 1996.Google Scholar
8Solomons, N, Mazariegos, M, Brown, KH, Klassing, K. The underprivileged developing country child: environmental contamination and growth failure revisited. Nutrition Reviews 1993; 51: 327–32.CrossRefGoogle ScholarPubMed
9Elia, M, Jebb, SA. Changing concepts of energy requirements in critically ill patients. Current Medical Literature Clinical Nutrition 1992; 1: 35–8.Google Scholar
10Elia, M. Changing concepts of nutrient requirements in disease: implications for artificial nutritional support. Lancet 1995; 345: 1279–84.CrossRefGoogle ScholarPubMed
11Eddy, TP, Nicholson, AL, Wheeler, EF. Dietary requirements in cerebral palsy. Developmental Medicine and Child Neurology 1965; 7: 377–86.CrossRefGoogle Scholar
12Phelps, WM. Dietary requirements in cerebral palsy. Journal of the American Dietetic Association 1951; 27: 869–70.CrossRefGoogle ScholarPubMed
13Elia, M, Jones, MG, Jennings, G, Poppitt, SD, Fuller, NJ, Murgatroyd, PR, Jebb, SA. Estimation of energy expenditure from specific activity of urine urea during lengthy subcutaneous NaH14CO3 infusion. American Journal of Physiology 1995; 269: E172–82.Google ScholarPubMed
14Gibney, E, Elia, M, Jebb, SA, Murgatroyd, P, Jennings, G. Total energy expenditure in patients with small cell lung cancer: results of a validated study using the bicarbonate-urea method. Metabolism 1996; 46: 1412–17.CrossRefGoogle Scholar
15Paton, NIJ, Angus, B, Chaowagul, W, Simpson, AJ, Suputtamonkol, M, Calder, G, Milne, E, White, NJ, Griffin, GE. Protein and energy metabolism in chronic bacterial infections: studies with melioidosis. Clinical Science 2001; 100: 101–10.CrossRefGoogle ScholarPubMed
16Gardner, AW, Poelman, ET. Assessment of free-living daily physical activity in older claudicants: validation against the doubly labelled water method. Journal of Gerontology 1998; 53A: M275–80.Google Scholar
17Kramer, JA, Dewit, O, Elia, M. Relationship between physical activity level, performance status, and quality of life in patients with inoperable lung cancer. Proceeding of the Nutrition Society 1998; 57: 109A.Google Scholar
18Elmstahl, S. Energy expenditure, energy intake and body composition in geriatric long-stay patients. Comprehensive Gerontology 1987A; 1(3): 118–25.Google ScholarPubMed
19van den Berg-Emons, R, Saris, WHM, Westerterp, KR, van Baak, MA. Heart rate monitoring to assess energy expenditure in children with reduced physical activity. Medicine and Science in Sports and Exercise 1996; 28: 496–501.CrossRefGoogle ScholarPubMed
20Bandini, LG, Schoeller, DA, Fugakawa, NK, Wykes, LJ, Dietz, WH. Body composition and energy expenditure in adolescents with cerebral palsy or myelodysplasia. Pediatric Research 1991; 29: 70–9.CrossRefGoogle ScholarPubMed
21Kinney, JM, Lang, CL, Gump, FE, Duke, JH. Tissue composition of weight loss in surgical patients I elective operation. Annals of Surgery 1968; 168: 459–74.CrossRefGoogle ScholarPubMed
22Royall, D, Fairfolm, L, Peters, WJ, Jeejeebohy, KN, Allard, JP. Continuous measurement of energy expenditure in ventilated burn patients: an analysis. Critical Care Medicine 1994; 22: 399–406.CrossRefGoogle ScholarPubMed
23Welsh, FA, Ginsberg, MD, Reider, W, Budd, WW. Deleterious effect of glucose pretreatment on recovery from diffuse cerebral ischemia in the cat. II. Regional metabolic levels. Stroke 1980; 11: 355–63.CrossRefGoogle Scholar
24Murray, MJ, Murray, AB. Anorexia as method of host defence. American Journal of Clinical Nutrition 1979; 32: 593–6.CrossRefGoogle Scholar
25Brooks, M, Melnik, G. The refeeding syndrome. An approach to undertaking its complications and preventing its recurrence. Pharmacotherapy 1995; 15: 713–26.CrossRefGoogle Scholar
26Solomon, SM, Kirby, DF. The refeeding syndrome: a review. Journal of Parenteral and Enteral Nutrition 1990; 14: 90–7.CrossRefGoogle ScholarPubMed
27Elia, M, Livesey, G. Energy expenditure and fuel selection in biological systems: the theory and practice of calculations based on indirect calorimetry and tracer methods. World Review of Nutrition and Dietetics 1992; 70: 68–.CrossRefGoogle ScholarPubMed
28Kinney, JM, Long, CL, Gump, JH, Duke, JH. Tissue composition of weight loss in surgical patients I. Elective operation. Annals of Surgery 1968; 168: 459–74.CrossRefGoogle ScholarPubMed
29Gibney, E, Jebb, SA, Jennings, G, Murgatroyd, PR, Elia, M. Measurement of total energy expenditure in patients with lung cancer and validation of the bicarbonate urea method against whole body indirect calorimetry. Proceedings of the Nutrition Society 1968; 56: 226A.Google Scholar
30Elia, M. Tissue distribution and energetics in weigh loss and undernutrition. In: Kinney, JM, Tucker, HN eds. Physiology, Stress and Malnutrition: Functional Correlates and Nutritional Intervention. New York: Lipcott-Raven, 1997.Google Scholar
31Elia, M. Organ and tissue contribution to metabolic rate. In: Kinney, JM, Tucker, HN, eds. Energy Metabolism: Tissue Determinants and Cellular Corollaries. New York: Raven Press, 1992; 61–79.Google Scholar
32Elia, M, Ritz, P, Stubbs, RJ. Energy expenditure in the elderly. European Journal of Clinical Nutrition 2000; 54: (Suppl. 3): S92–103.CrossRefGoogle ScholarPubMed
33Paton, NIJ, Elia, M, Jebb, SA, Jennings, G, Macallan, DC, Griffin, GE. Measurements of total energy expenditure in patients with human immunodeficiency virus infection using the bicarbonate urea method. Proceedings of the Nutrition Society 1996; 55: 154A.Google Scholar
34Valencia, ME, McNeill, G, Haggarty, P, Moya, SY, Pinelli, A, Quihui, L, Davalos, R. Energetic consequences of mild Giardiasis instestinalis infestationin Mexican children. American Journal of Clinical Nutrrition 1995; 61: 860–5.CrossRefGoogle Scholar
35Casper, RC, Schoeller, DA, Kushner, R, Hnilicka, J, Gold, ST. Total daily energy expenditure and activity level in anorexia nervosa. American Journal of Clinical Nutrition 1991; 53: 1143–50.CrossRefGoogle ScholarPubMed
36van Marken Lichtenbelt, WD, Heidendal, GAK, Westerterp, KR. Energy expenditure and physical activity in relation to bone mineral density in women with anorexia nervosa. European Journal of Clinical Nutrition 1991; 51: 826–30.CrossRefGoogle Scholar
37Bessey, PQ, Wilmore, DW. The burned patient. In: Kinney, JM, Jeejeebhoy, KN, Hill, GL, Owen, OE, eds. Nutrition and Metabolism in Patient Care. London: W.B. Saunders, 1988 672–700.Google Scholar
38Elia, M. Hunger disease: Metabolic response to starvation, injury and sepsis. Clinical Nutrition 2000; 19: 379–86.CrossRefGoogle Scholar
39Stallings, VA, Zemel, BS, Davies, JC, Cronk, CE, Charney, EB. Energy expenditure of children and adolescents with severe disabilities: a cerebral palsy model. American Journal of Clinical Nutrition 1994; 64: 627–34.CrossRefGoogle Scholar
40WHO. Energy and Protein Requirements. Report of a Joint FAO/WHO/UNU Expert Consultation Technical Report Series No. 724. Geneva: World Health Organization, 1985.Google Scholar
41Johnson, RK, Hildreth, HG, Contompasis, SH, Goran, MI. Total energy expenditure in adults with cerebral palsy as assessed by doubly labelled water. Journal of the American Dietetic Association 1997; 97: 966–70.CrossRefGoogle Scholar
42Shepherd, RW, Vasquez-Velasquez, L, Prentice, A, Holt, TL, Coward, WA, Lucas, A. Increased energy expenditure in young children with cystic fibrosis. Lancet 1988; I: 1300–3.CrossRefGoogle Scholar
43Spicher, V, Roulet, M, Schulz, Y. Assessment of total energy expenditure in free-living patients with cystic fibrosis. Journal of Pediatrics 1991; 118: 865–72.CrossRefGoogle ScholarPubMed
44Tomezsko, JL, Stallings, VA, Kawchak, DA, Goin, JE, Diamond, G, Scanlin, TF. Energy expenditure and genotype of children with cystic fibrosis. Pediatrics 1994; 35: 451–60.Google ScholarPubMed
45Barden, EM, Zemel, BS, Kawchak, DA, Goran, MI, Ohene-Frempong, K, Stallings, V. Total and resting energy expenditure in children with sicklecell disease. Journal of Pediatrics 2000; 136: 73–9.CrossRefGoogle Scholar
46Barton, J, Hindmarsh, P, Scrimgeour, C, Rennie, M, Preece, M. Energy expenditure in congenital heart disease. Archives of Diseases of Children 1994; 70: 5–9.CrossRefGoogle ScholarPubMed
47Mitchel, P, Davies, P, Day, P, Pollock, J, Jamieson, M, Wheatley, D. Energy expenditure in children with congenital heart disease before and after cardiac surgery. Journal of Thoracic and Cardiovascular Surgery 1994; 107: 374–80.CrossRefGoogle Scholar
48Leitch, CA, Karn, CA, Peppard, RJ, Granger, D, Leichty, EA, Ensing, GL, Denne, SC. Increased energy expenditure in infants with cyanotic congenital heart disease. Journal of Pediatrics 1998; 133: 755–60.CrossRefGoogle ScholarPubMed
49Ackerman, IL, Karn, CA, Denne, SC, Ensing, GJ, Leitch, CA. Total but not resting energy expenditure is increased in infants with ventricular septal defect. Pediatrics 1998; 102: 1172–7.CrossRefGoogle ScholarPubMed
50Schoeller, D, Levitsky, LL, Bandini, LG, Dietz, WW, Walczak, A. Energy expenditure and body compositionin Prader-Willi syndrome. Metabolism 1988; 37: 115–20.CrossRefGoogle Scholar
51Motil, KJ, Schultz, RJ, Wong, WW, Glaze, DG. Increased energy expenditure associated with repetitive involuntary movement does not contribute to growth failure in girls with Rett syndrome. Journal of Pediatrics 1998; 132: 228–32.CrossRefGoogle Scholar
52Leitch, CA, Ahlrichs, J, Karn, C, Denne, SC. Energy expenditure and energy intake during dexamethasone therapy for chronic lung disease. Pediatric Research 1999; 46: 109–13.CrossRefGoogle ScholarPubMed
53Goran, MI, Peters, EJ, Herndon, DN, Wolfe, RR. Total energy expenditure in burned children using doubly labelled water technique. American Journal of Physiology 1990; 259: E576–85.Google Scholar
54Diaz, E, Goldberg, GR, Taylor, M, Savage, JM, Sellen, D, Coward, WA, Prentice, AM. Effect of dietary supplementation on work performance in Gambian labourers. American Journal of Clinical Nutrition 1991; 53: 803–11.CrossRefGoogle Scholar
55Heini, AF, Minghelli, G, Diaz, E, Prentice, AM, Schutz, Y. Free-living energy expenditure assessed by two different methods in rural Gambian men. European Journal of Clinical Nutrition 1996; 50: 284–9.Google ScholarPubMed
56Burstein, R, Coward, AW, Askew, WA, Carmel, K, Irving, C, Shpilberg, O, Moran, D, Pikarsky, A, Grinot, G, Sawyer, M, Golan, R, Epstein, Y. Energy expenditure variations in soldiers performing military activities under cold and hot climate conditions. Military Medicine 1996; 161: 750–4.CrossRefGoogle ScholarPubMed
57Forbes-Ewan, CH, Morrissey, BLL, Gregg, GC, Waters, DR. Use of doubly labelled water technique in soldiers training for jungle warfare. Journal of Applied Physiology 1989; 67: 14–8.CrossRefGoogle ScholarPubMed
58Saris, W. Limits of human endurance: lessons from the Tour de France. In: Kinney, JM, Tucker, HN, eds. Physiology, Stress and Malnutrition: Functional Correlates, Nutritional Intervention. New York: Lippincott-Raven Publishers, 1997 451–62.Google Scholar
59Branth, S, Hambraeus, L, Westerterp, K, Andersson, A, Edsgren, R, Mustelin, M, Nilsson, R. Energy turnover in a sailing crew during offshore racing around the world. Medicine and Science in Sports and Exercise 1996; 28: 1272–6.CrossRefGoogle Scholar
60Reynolds, RD, Lickteig, JA, Deuster, PA, Howard, MP, Conway, JM, Pietersma, A, deStoppelaar, J, Deurenberg, P. Energy metabolism increases and regional body fat decreases while regional muscle mass is spared in humans climbing Mt. Everest. Journal of Nutrition 1999; 129: 1307–14.CrossRefGoogle ScholarPubMed
61Westerterp, KR, Kayser, B, Brouns, F, Herry, JP, Saris, WHM. Energy expenditure climbing Mt. Everest. Journal of Applied Physiology 1992; 73: 1815–9.CrossRefGoogle ScholarPubMed
62Stroud, MA. Thermoregulation, exercise, and nutrition in the cold: investigations on a polar expedition. In: Kinney, JM, Tucker, HN, eds. Physiology, Stress, and Malnutrition: Functional Correlates, Nutritional Intervention. New York: Lippincott-Raven Publishers, 1997; 531–48.Google Scholar
63Wood, CD, Mansfield, ER. Studies of the Food of Maine Lumbermen. Bulletin no. 149. Washington, DC: US Department of Agriculture, 1904.Google Scholar
64Kashiwazaki, H, Dejima, Y, Orias-Rivera, J, Coward, WA. Energy expenditure determined by the doubly labelled water method in Bolivian Arymara living in a high altitude agro-pastoral community. American Journal of Clinical Nutrition 1995; 62: 901–10.CrossRefGoogle Scholar
65Singh, J, Prentice, AM, Diaz, E, Coward, WA, Ashford, JA, Sawyer, M, Whitehead, R. Energy expenditure of Gambian women during peak agricultural activity measured by the doubly labelled water method. British Journal of Nutrition 1995; 62: 315–29.CrossRefGoogle Scholar
66Stein, TP, Johnston, FE, Greiner, L. Energy expenditure and socioeconomic status in Guatemala as measured by the doubly labelled water method. American Journal of Clinical Nutrition 1988; 47: 196–200.CrossRefGoogle ScholarPubMed
67Esparza, J, Fox, C, Harper, IT, Bennett, PH, Schulz, LO, Valencia, ME, Ravussin, E. Daily energy expenditure in Mexican and USA Pima Indians: low physical activity as a cause of obesity. International Journal of Obesity 2000; 24: 55–9.CrossRefGoogle Scholar
68Westerterp, KR, Meijer, GA, Janssen, EME, Saris, WHM, Hoor, FT. Long-term effect of physical activity on energy balance and body composition. British Journal of Nutrition 1992; 68: 21–30.CrossRefGoogle ScholarPubMed
69van Etten, MLA, Westerterp, KR, Verstappen, FTJ, Boon, BJB, Saris, WHM. Effect of an 18-wk weight-training program on energy expenditure and physical activity. Journal of Applied Physiology 1997; 82: 298–304.CrossRefGoogle ScholarPubMed
70Blaak, EE, Westerterp, KR, Bar-Or, O, Wouters, LJ, Saris, WH. Total energy expenditure and spontaneous activity in relation to training in obese boys. American Journal of Clinical Nutrition 1992; 55: 777–82.CrossRefGoogle ScholarPubMed
71Bingham, SA, Goldberg, GR, Coward, WA, Prentice, AM, Cummings, JH. The effect of exercise and improved physical fitness on basal metabolic rate. British Journal of Nutrition 1989; 61: 155–73.CrossRefGoogle ScholarPubMed
72Goran, MI, Poelman, ET. Endurance training does not enhance total energy expenditure in healthy elderly persons. American Journal of Physiology 1992; 263: E950–7.Google Scholar
73Westerterp, KR. Alterations of energy balance with exercise. American Journal of Clinical Nutrition 1998; 68(Suppl. 1): 1998 S970–S4.CrossRefGoogle ScholarPubMed
74Hunter, GR, Wetzstein, GJ, Fields, DA, Brown, A, Bamman, MM. Resistance training increases total energy expenditure and free-living physical activity in older adults. Journal of Applied Physiology 2000; 87: 977–84.CrossRefGoogle Scholar
75Gottlieb, SS, Fisher, ML, Freudenberger, R, Robinson, S, Zietowski, G, Alves, L, Krichten, C, Vaitkevicus, P, McCarter, R. Effects of exercise training on peak performance and quality of life in congestive heart failure patients. Journal of Cardiac Failure 1999; 5: 188–94.CrossRefGoogle ScholarPubMed
76Gardner, AW, Womack, CJ, Sieminski, DJ, Montgomery, PS, Killewich, LA, Fonong, T. Relationship between free-living daily physical activity and ambulatory measures in older claudicants. Angiology 1998; 49: 327–37.CrossRefGoogle ScholarPubMed
77Gardner, AW, Killewich, LA, Katzel, LI, Womack, CJ, Montgomery, PS, Otis, RB, Fonong, T. Relationship between free-living daily physical activity and peripheral circulation in patients with intermittent claudication. Angiology 1999; 50: 289–97.CrossRefGoogle ScholarPubMed
78Otis, RB, Brown, AS, Womack, CJ, Fonong, T, Gardner, AW. Relationship between physical activity recall and free-living daily physical activity. Angiology 2000; 51: 181–8.CrossRefGoogle ScholarPubMed
79Toth, MJ, Gottlieb, SS, Fisher, ML, Poelman, ET. Daily energy expenditure in heart failure patients. Metabolism 1997; 46: 1294–8.CrossRefGoogle ScholarPubMed
80Poelman, ET. Special considerations in design of trials with elderly subjects: unexplained weight loss, body composition and energy expenditure. Journal of Nutrition 1999; 129: S260–S3.CrossRefGoogle Scholar
81Poelman, ET, Toth, MJ, Goran, MI, Carpenter, WH, Newsholme, P, Rosen, CJ. Daily energy expenditure in free-living non-institutionalised Alzheimer's patients. Neurology 1997; 48: 997–1002.CrossRefGoogle Scholar
82Poelman, ET, Dvorak, R. Energy expenditure, energy intake, and weight loss in Alzheimer's disease. American Journal of Clinical Nutrition 2000; 71(Suppl.): S650–S5.CrossRefGoogle Scholar
83Dvorak, RV, Poelman, ET. Appendicular skeletal musclemass, physical activity, and cognitive status in patients with Alzheimer's disease. Neurology 1998; 51: 1386–90.CrossRefGoogle Scholar
84Toth, MJ, Fishman, PS, Poelman, ET. Free-living daily energy expenditure in patients with Parkinson's disease. Neurology 1997; 48: 88–91.CrossRefGoogle ScholarPubMed
85Pratley, R, Salbe, AD, Ravussin, E, Caviness, JN. Higher sedentary energy expenditure in patients with Huntington's disease. Annals of Neurology 2000; 47: 64–70.3.0.CO;2-S>CrossRefGoogle ScholarPubMed
86Pullicino, E, Coward, A, Elia, M. Total energy expenditure in intravenously fed patients measured by the doubly labelled water technique. Metabolism 1993; 42: 58–64.CrossRefGoogle Scholar
87Schoeller, DA, Kushner, RF, Jones, PJH. Validation of doubly labelled water for measuring energy expenditure during parenteral nutrition. American Journal of Clinical Nutrition 1986; 44: 291–8.CrossRefGoogle ScholarPubMed
88Kushner, RF, Schoeller, DA. Resting and total energy expenditure in patients with inflammatory bowel disease. American Journal of Clinical Nutrition 1991; 53: 161–5.CrossRefGoogle ScholarPubMed
89Carlsson, M, Nordenstrom, J, Hedenstierna, G. Clinical implications of continuous measurement of energy expenditure in mechanically ventilated patients. Clinical Nutrition 1984; 3: 103–10.CrossRefGoogle ScholarPubMed
90Weekes, E, Elia, M. Observations on the patterns of 24 hour energy expenditure and changes in body composition and gastric emptying in head injured patients. Journal of Parenteral and Enteral Nutrition 1996; 20: 31–7.CrossRefGoogle ScholarPubMed
91Wall-Alonso, E, Schoeller, DA, Schechter, L, Gottlieb, LJ. Measured total energy requirements of adult patients with burns. Journal of Burn Care and Rehabilitation 1999; 20: 329–37.Google ScholarPubMed
92Novick, WM, Nusbaum, M, Stein, TP. The energy costs of surgery as measured by the doubly labelled water (2H218O) method. Surgery 1988; 103: 99–105.Google ScholarPubMed
93Taggart, DP, McMillan, DC, Preston, C, Richardson, R, Burns, RJG, Wheatley, DJ. Effects of cardiac surgery and intraoperative hypothermia on energy expenditure as measured by doubly labelled water. British Journal of Surgery 1991; 78: 237–41.CrossRefGoogle ScholarPubMed
94Schofield, WN, Schofield, C, James, WPT. Basal Metabolic Rate. Human Nutrition: Clinical Nutrition 1985; 39(C): 1–96.Google ScholarPubMed
95Elia, M. Artificial feeding: requirements and complications. Medicine International 1994; 22: 411–5.Google Scholar