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024 7 _ |a 10.1186/s13054-025-05695-y
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037 _ _ |a DKFZ-2025-02264
041 _ _ |a English
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100 1 _ |a von Renesse, Janusz
|0 0000-0002-5103-5137
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245 _ _ |a Indirect calorimetry identifies hypermetabolism associated with muscle wasting and increased risk of energy deficit in ICU patients.
260 _ _ |a London
|c 2025
|b BioMed Central
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520 _ _ |a Muscle mass loss is a major contributor to morbidity and mortality in Intensive Care Unit (ICU) patients, but the role of metabolic state - particularly energy expenditure - in this process remains unclear. This study investigates the association between metabolic status and muscle mass loss in critically ill adults using indirect calorimetry and CT imaging assessed muscle quantification.In this observational study, adult ICU patients with at least two indirect calorimetry measurements and matched abdominal CT scans were included. Resting energy expenditure (REE) was measured by indirect calorimetry, and muscle mass was quantified as the cross-sectional area (CSA) of the posterior muscle group at the L3 vertebral level. Statistical analyses included regression modeling and group comparisons.The observational study included 88 patients (n = 88), all of whom underwent at least two calorimetric measurements with corresponding CT scans, and 43 patients (n = 43) had at least three assessments. Persistently elevated normalized energy expenditure per kilogram of body weight (nREE) was independently associated with greater muscle loss. Patients classified as hypermetabolic by nREE experienced significantly more muscle wasting than those with lower metabolic activity. Hypermetabolism was associated with increased inflammatory markers, while sedation or agitation (RAAS) and higher level of consciousness (GCS) were not related to metabolic state.Persistent hypermetabolism in ICU patients is independently associated with accelerated muscle mass loss. Early identification of hypermetabolic patients using indirect calorimetry may enable targeted nutritional interventions to reduce muscle mass wasting and improve clinical outcomes.
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650 _ 7 |a Cachexia
|2 Other
650 _ 7 |a Critical illness
|2 Other
650 _ 7 |a Hypermetabolic patients
|2 Other
650 _ 7 |a Hypermetabolism
|2 Other
650 _ 7 |a Hypermetabolizers
|2 Other
650 _ 7 |a Indirect calorimetry
|2 Other
650 _ 7 |a Intensive care unit (ICU)
|2 Other
650 _ 7 |a Muscle loss
|2 Other
650 _ 7 |a Muscle wasting
|2 Other
650 _ 7 |a Resting energy expenditure (REE)
|2 Other
650 _ 7 |a Sarcopenia
|2 Other
650 _ 2 |a Humans
|2 MeSH
650 _ 2 |a Calorimetry, Indirect: methods
|2 MeSH
650 _ 2 |a Male
|2 MeSH
650 _ 2 |a Female
|2 MeSH
650 _ 2 |a Middle Aged
|2 MeSH
650 _ 2 |a Intensive Care Units: organization & administration
|2 MeSH
650 _ 2 |a Intensive Care Units: statistics & numerical data
|2 MeSH
650 _ 2 |a Aged
|2 MeSH
650 _ 2 |a Energy Metabolism: physiology
|2 MeSH
650 _ 2 |a Critical Illness
|2 MeSH
650 _ 2 |a Muscular Atrophy: physiopathology
|2 MeSH
650 _ 2 |a Adult
|2 MeSH
650 _ 2 |a Tomography, X-Ray Computed: methods
|2 MeSH
700 1 _ |a von Kessel, Moritz Karl Friedrich
|b 1
700 1 _ |a Oehme, Florian
|b 2
700 1 _ |a Kirchberg, Johanna
|b 3
700 1 _ |a Kalandarishvili, Mikheil
|b 4
700 1 _ |a Nebelung, Heiner
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700 1 _ |a Merboth, Felix
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700 1 _ |a Mirtschink, Peter
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700 1 _ |a Weitz, Jürgen
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700 1 _ |a Distler, Marius
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700 1 _ |a Held, Hanns-Christoph
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700 1 _ |a Kühn, Jens-Peter
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700 1 _ |a Meisterfeld, Ronny
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773 _ _ |a 10.1186/s13054-025-05695-y
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