Proefschrift Kerklaan

Chapter 4

An RQ of administered macronutrients (RQ macr ) was calculated based on the modified Lusk table after determination of the ratio of carbohydrate to fat for the total nonprotein calories of the intake provided on the day of the measurement 29 . The measured RQ was compared to the RQ macr . The RQ was assumed to approximate the RQ macr , if RQ = RQ macr ± 0.05 29,30 . No corrections were made for losses of macronutrients in stools when EN was given 39 . The following definitions of energy overfeeding were used and compared:

1) Caloric intake/mREE >110%

2) Caloric intake/mREE >120%

+ 0.05

3) RQ > RQ

macr

Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 21.0 (Released 2012. SPSS Armonk, NY: IBM Corp.). Results are expressed as proportion, mean and standard deviation, or median and interquartile range (IQR). Differences between groups were analyzed by use of the Mann-Whitney and Kruskal-Wallis test. Pearson’s correlation coefficient (r) was used to evaluate the strength of the relation between RQ and carbohydrate intake, and between the continuous variables on which the definitions are based: RQ-RQ macr and the ratio caloric intake/mREE. Linear regression analysis was used to further define the relation between RQ-RQ macr and the ratio caloric intake/mREE. Two-tailed P-values <0.05 were considered significant. Patients Measurements were performed in 78 children (51 boys). Clinical and nutritional characteristics are shown in Table 2. Median age was 6.3 (Interquartile Range [IQR]1.5 to 29.3) months. An SD-score for WFA<-2 was found in 23 children (30%). The reason for admission was medical in 77% of the children, with 32% respiratory insufficiency. The median length of stay at the time of measurement was 1 day (IQR 1 to 3) after PICU admission. All children were mechanically ventilated and sedated withmidazolam and/or morphine. Seventy-four percent of the children received EN; 57% were fed by EN exclusively; and 18% received a mixture of EN and PN. Total PN was provided in 15% of the children; 10% of the children received only glucose infusion at time of measurement. RESULTS

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