Energy Expenditure in Critically Ill Children

Energy expenditure in critically ill children is a key determinant for nutritional caloric delivery in critically ill children. However, its methods of measurement are poorly available, and its prediction is unreliable and imprecise with currently available methodology. This thesis seeks to better understand patient and clinical factors related to energy expenditure to improve its prediction. In the first study, we conducted a systematic review to determine the patient and clinical factors associated with energy expenditure in critically ill patients. We described the limitations of currently available data and identified important factors that are not included in current prediction formulae of the critically ill. In the second study, we conducted a retrospective study at two Canadian centers to describe some predictors of energy expenditure in this population and estimate their magnitude of effect. We were able to describe some factors of interest in critically ill children, identify factors that were not evaluated in sufficient numbers, and determine new predictors associated with energy expenditure not previously described in paediatric ICU. In the third study, we aimed to establish a prospective cohort of critically ill children with indirect calorimetry measurements and clinical data to support the development and initial validation of an equation that predicts energy expenditure. This thesis achieved its intended aims and the work provides the foundation for the development of an energy expenditure equation that is reliable, valid, accessible, and widely applied in critically ill children.

Department dc:contributor.department

Health Policy, Management and Evaluation

Year dc:date.issued

2022

Author dc:creator

• Mtaweh, Haifa

Advisor dc:contributor.advisor

• Parshuram, Christopher

• Critical illness
• Energy Expenditure

Statement dc:rights

• Attribution-NonCommercial-NoDerivatives 4.0 International

Licence dc:rights.uri

• http://creativecommons.org/licenses/by-nc-nd/4.0/

Handle dc:identifier.uri

http://hdl.handle.net/1807/139031

OAI identifier oai:identifier

oai:utoronto.scholaris.ca:1807/139031