﻿ Determination of the Resting Energy Expenditure in Hospitalized / Critically ill Patients - Ireton-Jones Equations
Determination of the Resting Energy Expenditure in
Hospitalized / Critically ill Patients
Ireton-Jones Equations
Age:       Gender:
Current weight:

## Background

Equations are listed below.   The final selection of equations was based on  information found within the ADA evidence library and the following reference:

Walker RN, Heuberger RA. Predictive Equations for Energy Needs for the Critically Ill. Respir Care 2009;54(4):509 –521.

Direct quotes:    "Understanding an equation’s reference population and using the equation with similar patients are essential for the equation to perform similarly. Prediction accuracy among equations is rarely within 10% of the measured energy expenditure; however, in the absence of indirect calorimetry, a prediction equation is the best alternative."       "However, if an equation must be used, the 1998 and 2003 Penn State equations, the 1992 Ireton-Jones equation, and the Swinamer equation are worthy of consideration."

Important note:  during the next update, additional equations may be added. This initial version will only calculate results for the Ireton-Jones equations.

#### Ireton-Jones Energy Equations IJEE

Ventilator-dependent:
IJEE(v) = 1784 - 11(A)+ 5(W)+244 (G) + 239(T) + 804(B)
2002 version (revised 1997 equation).

IJEE(v) = 1925 - 10(A) + 5(W) +281 (G) +292 (T) +851 (B)
1992 version

Spontaneously Breathing:
IJEE(s) = 629 - 11 (A) + 25 (W) - 609 (O)

IJEE = kcal/day; A = age (yrs); W = actual wt(kg); G = gender(male=1, female=0); T = trauma, B = burn, O=obesity( if present=1, absent=0)

References:
Ireton-Jones C, Jones JD. Improved equations for predicting energy expenditure in patients: The Ireton-Jones equations. Nutr Clin Pract. 2002;17:29-31.

Ireton-Jones CA, Turner WW, Liepa GU, Baxter CR. Equations for the estimation of energy expenditures in patients with burns with special reference to ventilatory status. J Burn Care Rehabil 1992; 13(3):330-333.  http://www.carolireton-jones.com/

#### Harris Benedict Equations must be used with a custom stress factor:

BMR calculation for men (metric)
BMR = 66.47 + ( 13.75 x weight in kg ) + ( 5.003 x height in cm ) - ( 6.755 x age in years )

BMR calculation for women (metric)
BMR = 655.1 + ( 9.563 x weight in kg ) + ( 1.850 x height in cm ) - ( 4.676 x age in years )

Reference: Harris JA, Benedict FG. A biometric study of human basal metabolism. Proc Natl Acad Sci USA 1918;4(12):370-3.

#### Penn State Equations

Penn State 1998 equation
(1.1 x value from Harris-Benedict equation - use ajbw if obese) + (140 x Tmax)+ (32 x VE) - 5340

Penn State 2003 equation
(0.85 x value from Harris-Benedict equation) + (175 x Tmax) + (33 x VE) - 6,433

Reference:
Frankenfield D, Smith S, Cooney RN. Validation of 2 approaches to predicting resting metabolic rate in critically ill patients. JPEN J Parenter Enteral Nutr 2004;28(4):259-264.

#### Swinamer 1990 equation

(945 x body surface area) - (6.4 x age) + (108 x temp in celsius) + (24.2 x respiratory rate in breaths/min) + (817 x VT) - 4349

Reference:
Swinamer DL, Grace MG, Hamilton SM, Jones RL, Roberts P, King G. Predictive equation for assessing energy expenditure in mechanically ventilated critically ill patients. Crit Care Med 1990;18(6):657-661.

## Disclaimer

All calculations must be confirmed before use. The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer
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