# Ireton-Jones Energy requirements -critical care

##
**Ireton-Jones Energy Equations - IJEE**

## Determination of the Resting Energy Expenditure in Hospitalized / Critically ill Patients

## 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 equations 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."

Direct quotes: "Understanding an equations 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:**

**Age**:

**Gender**:

**Weight**:

## Select all that apply

## Dieting - BMR - RMR Calculators:

*Several of these calculators may be particularly useful for dieters. Just about every single MAJOR calorie/ energy equation that has been released over the last 90 years is included below. Each calculator has a customized printout option for easy analysis. Recommendation: Try each calculator - print out the results - then compare!*

**:**

*Estimated 'Calorie' Calculators*

*Harris-Benedict Equation*

*: Estimation of total calories needed. MOST widely used equation for calculating basal metabolic rate and total calories.*

*Revised Harris-Benedict Equation*

*:The original Harris Benedict equation was revised in 1984. This updated equation can be used to calculate the basal metabolic rate and total calories.*

*RESTING Metabolic Rate (RMR)*

*: Resting Metabolic Rate Calc - This equation can be used to calculate the RESTING metabolic rate and total calories. Mifflin-St Jeor equation.*

*Schofield equation (BMR)*

*: This equation was part of the previous government guidelines to formulate RDA's and can be used to calculate the basal metabolic rate and total calories needed.*

*Institute of Medicine Equation- LATEST EQUATION*

*: IOM Equation-Estimated Energy Requirement (EER) Estimation of total calories needed. This equation is behind the 2005 Dietary Guidelines for Americans and the new food pyramid, MyPyramid.*

*Check out the new BMR multi-calc*

*.*

## Background

## 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)

No additional factor is added for activity or injury

## Other equations to consider

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

BMR calculation for men (metric)

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.

## Reference

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. https://www.carolireton-jones.com/