[P2-50] Energy requirement assessed by doubly-labeled water method in individuals with quadriplegic cerebral palsy (GMFCS level V)
[Introduction] Anthropological-based approaches to calculate total energy expenditure (TEE) in typically developing individuals are inaccurate in individuals with cerebral palsy (CP). Indirect calorimetry with a facemask are more accurate, but is uncomfortable in children. Measuring TEE using doubly labeled water (DLW) methods is the gold standard, but precise quantities of saliva and urine specimens can be difficult to obtain in severe CP. Thus an accurate, indirect approach that can be more precisely estimate TEE requirements is needed.
[Objective] We compared TEE from urine samples utilizing urethral catheterization and TEE from blood samples using the DLW method in individuals with CP. We determined whether indirect calorimetry using a ventilated-hood measure resting metabolic rate (RMR) can be used to estimate TEE measured from the DLW.
[Methods] 10 bedridden individuals with GMFCS level V quadriplegic CP (1-22yrs) participated. TEE was measured using the DLW method. Urine and blood samples were taken immediately before DLW administration and 1,2,7, and 8 days later. TEE of blood (TEE-b) and urine (TEE-u) were calculated respectively. Total energy intake (TEI) was calculated from food intake.
[Results] TEE-u and TEE-b estimated by DLW method were 941±174 and 913±130kcal/day, respectively. There was a significant correlation (r=0.97, p<0.01) between TEE-u and TEE-b. Mean error between TEE-u and TEE-b was 4.9±3.9%, with TEE-u being 2.1% higher. Preliminary analysis of RMR from the ventilated-hood suggests similar results to DLW methods.
[Conclusions] TEE-b can be used to accurately measure TEE. Measure RMR using a non invassive ventilated-hood to estimate TEE may be promising.
[Objective] We compared TEE from urine samples utilizing urethral catheterization and TEE from blood samples using the DLW method in individuals with CP. We determined whether indirect calorimetry using a ventilated-hood measure resting metabolic rate (RMR) can be used to estimate TEE measured from the DLW.
[Methods] 10 bedridden individuals with GMFCS level V quadriplegic CP (1-22yrs) participated. TEE was measured using the DLW method. Urine and blood samples were taken immediately before DLW administration and 1,2,7, and 8 days later. TEE of blood (TEE-b) and urine (TEE-u) were calculated respectively. Total energy intake (TEI) was calculated from food intake.
[Results] TEE-u and TEE-b estimated by DLW method were 941±174 and 913±130kcal/day, respectively. There was a significant correlation (r=0.97, p<0.01) between TEE-u and TEE-b. Mean error between TEE-u and TEE-b was 4.9±3.9%, with TEE-u being 2.1% higher. Preliminary analysis of RMR from the ventilated-hood suggests similar results to DLW methods.
[Conclusions] TEE-b can be used to accurately measure TEE. Measure RMR using a non invassive ventilated-hood to estimate TEE may be promising.