NUTRITION AND THE INTENSIVE CARE UNIT: Edited by Mette Berger and Jeffrey I. MechanickThe use of indirect calorimetry in the intensive care unitMcClave, Stephen A.a; Martindale, Robert G.b; Kiraly, LaszlobAuthor Information aDepartment of Medicine, University of Louisville School of Medicine, Louisville, Kentucky bDepartment of Surgery, Oregon Health Sciences University, Portland, Oregon, USA Correspondence to Stephen A. McClave, MD, Professor of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Louisville School of Medicine, Louisville, KY 40202, USA. Tel: +1 502 852 7963; fax: +1 502 852 0846; e-mail: Stephen.McClave@louisville.edu Current Opinion in Clinical Nutrition and Metabolic Care: March 2013 - Volume 16 - Issue 2 - p 202-208 doi: 10.1097/MCO.0b013e32835dbc54 Buy Metrics Abstract Purpose of review This review evaluates whether improvements have occurred in the value of predictive equations for use in designing nutritional therapeutic regimens in the ICU. The report also seeks to determine whether emerging strategies for nutrition therapy in the ICU change the need for an accurate measurement of energy requirements by indirect calorimetry. Recent findings Predictive equations remain problematic for use in the critically ill patient. Inaccuracy of predictive equations introduces error in the design of a nutritional therapy regimen. The epidemic of obesity renders the calculations of requirements by predictive equations increasingly inaccurate at extremes of BMI. Certain patient populations appear to be hypometabolic, contradicting the traditional notion that critical illness increases energy expenditure. More recent data indicates that determination of which patients benefit from nutritional therapy may be based both on assessment of nutrition risk and delivery of sufficient nutrition therapy. Summary The role of indirect calorimetry in the ICU should be expected to increase in the near future, as predictive equations may be too inaccurate to identify the appropriate goals of nutrition therapy. © 2013 Lippincott Williams & Wilkins, Inc.