Question 1

Why is indirect calorimetry preferred over predictive equations?

Accepted Answer

Predictive equations are inaccurate in up to 70% of critically ill patients. Indirect calorimetry measures actual O2 consumption and CO2 production, accounting for metabolic variability.

Question 2

What is the role of hypocaloric feeding in critically ill patients?

Accepted Answer

Trophic feeding at 10–20 kcal/hour for up to 7 days is acceptable in patients with shock on high-dose vasopressors. Protein intake should be prioritised over calories.

Question 3

How should I calculate protein needs in patients receiving CRRT?

Accepted Answer

CRRT results in amino acid losses of 10–15 g/day. Increase protein target to 1.5–2.5 g/kg/day to compensate.

Question 4

What is the optimal calorie target for obese ICU patients?

Accepted Answer

For BMI >30, SCCM/ASPEN recommends 22–25 kcal/kg ideal body weight per day. Protein: 2.0–2.5 g/kg IBW per day.