Question 1
Currently most facilities use Ireton-Jones for ventilated patients. Does this study change your views on using this method of energy prediction for those patients?
posted by Jordan @ 11:56 AM
13 comments
ISU Dietetic Internship Journal Club
Objective: To become familiar with current scientific literature on a variety of nutrition topics and to gain experience in gathering, organizing, critically evaluating, presenting and facilitating group discussion of the literature and the implications to practice.
13 Comments:
I can not say with confidence that this changes my views on using Ireton because this study looked at one disease (ALS). I think that this information and the results from this study could bring up this question in many facilities and perhaps open the door for more research to determine if Ireton should continue to be used.
This study does really show that there is no “one” correct method of calculating caloric needs in every situation. Though it does raise some questions for me about the accuracy of using this method for ventilator patients, one study does not change my overall view. The important point is to always use more than one method and compare!
I agree with Stephanie that this study served as a gateway for more research to be performed on specific disease states and REE calculations.
It does not change my view on using Ireton Jones for ventilated patients. The study only evaluated ALS patients. We cannot conclude from this study that the IJ method overestimates for all disease states. I agree with Brooke that more than one method should always be utilized when calculating needs.
This article definitely makes me think about the use of Ireton Jones for ventilated patients. I would like to see more research on the topic before I could make a conclusive decision. I think it would be wise for dietitians to calculate needs two different ways on ventilated patients such as Ireton Jones compared with Mifflin St. Jeor to see what the calorie difference is and choose the lower one. I think each individual patient's needs also depend on what other conditions the patient has going on.
I agree with Amanda and Brooke that there is no one "correct" way to calculate calorie needs. Amanda also brings up a great point that this study only includes ALS patients. More research is necessary to determine whether Ireton Jones over calculates needs for ventilated patients.
It does not make me question this equation if a patient with ALS needed to be on a ventilator. Ireton –Jones is used for patients on a vent for a reason and has been proven to be accurate. It does make me curious however as to other diseases and how these equations measure up to indirect calorimetry.
What great researchers we are becoming in our field. Sadly our conclusion is similar to many other studies, that more research is needed and many times there is no definitive answers.
Kevin, I agree that it would be interesting to see how these equations measure up to indirect calorimetry.
I think that it should be taken in consideration. However, when determining calorie needs it is always beneficial to use more than one equation and then use your personal judgement to determine the best ranges for each patient.
This does not change my opinion about the use of Ireton-Jones because it focuses on only one disease condition. The results of this study cannot be generalized to all other diseases and/or reasons patients may be put on a ventilator.
Brooke, you bring up a good point that can be easily forgotten in a busy clinical setting. There is no one right or wrong in the field of nutrition so it is important to use multiple methods to calculate needs and compare the outcomes.
Kevin, you bring up an excellent point of how interesting it would be to research the accuracy of indirect calorimetry of other diseases!
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