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Effect of PEEP on Indirect Calorimetry in Critically Ill Patients
Sponsor: Vastra Gotaland Region
Summary
Indirect calorimetry is used in intensive care to measure how much oxygen a patient consumes and how much carbon dioxide is produced. These measurements are used to estimate energy expenditure and help guide nutritional treatment. In mechanically ventilated patients, however, ventilator settings may potentially influence the accuracy of indirect calorimetry. This study will investigate whether changes in positive end-expiratory pressure (PEEP), a routinely used ventilator setting, affect measurements obtained by indirect calorimetry in critically ill mechanically ventilated adults. Each participant will undergo indirect calorimetry at three PEEP levels: 8, 12, and 16 cmH2O. Each PEEP level will be maintained for a stabilization period before measurements are obtained. Other ventilator settings will be kept unchanged during the measurement sequence whenever clinically feasible. The study will compare oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory quotient (RQ), and resting energy expenditure (REE) across the three PEEP levels. The aim is to determine whether clinically relevant changes in PEEP systematically influence indirect calorimetry measurements and their interpretation.
Official title: Effect of Positive End-Expiratory Pressure on Indirect Calorimetry Measurements in Mechanically Ventilated Critically Ill Patients: A Prospective Physiological Study
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
20
Start Date
2026-11-01
Completion Date
2028-10-01
Last Updated
2026-09-01
Healthy Volunteers
No
Interventions
Protocolized PEEP Adjustment
Positive end-expiratory pressure (PEEP) is adjusted sequentially to 8, 12, and 16 cmH2O during a single study session. Each level is maintained until the predefined stabilization criteria are met before indirect calorimetry measurements are obtained. The sequence is performed under continuous intensive care monitoring and is discontinued if clinically relevant deterioration occurs.