This study analyzed the acute effect of water consumption on resting metabolic rate (RMR). It was hypothesized that water would have a small, nonclinically significant effect on RMR. Men and women ages 18–40 years participated in a crossover study in which each participant received a No Water and Water condition (order determined randomly) with a 7-day washout period between each condition. Both conditions began with visual analog scales to gauge hunger and thirst levels, urine spectrometry to quantify hydration status, and height and weight measurements. The No Water condition consisted of a 30-minute rest period followed by 45 minutes of RMR testing. The Water condition was identical except for the administration of 500 ml of purified water at 3 °C 10 minutes prior to the beginning of the RMR measurement. Resting metabolic rate testing was done via indirect calorimetry. There was not a condition-by-time difference in 24-hour resting energy expenditure, oxygen consumption, or metabolic equivalents when including all data points and controlling for nonlinearity (ps > 0.0682). There was a significant difference in respiratory quotient (RQ) (F = 13.73; p = 0.0006) with the No Water condition showing a slightly higher RQ than the Water condition. The nonlinear pattern was primarily driven by the first several minutes of testing. Accordingly, we completed analyses without the first 5 minutes of data. The results persisted; that is, there was no condition-by-time effect in 24-hour resting energy expenditure, oxygen consumption, or metabolic equivalents (ps > 0.2435). Further, the RQ remained significantly different (F = 10.57; ps > 0.0023); however, it was slightly higher in the Water condition. This study did not support our hypothesis that consumption of 500 ml of water would have a measurable effect on RMR and fuel utilization compared to not consuming water. Rather, this study replicates other studies that suggest there is not an acute measurable effect of water consumption on RMR. Nevertheless, one positive application of these findings is that water may be a suitable control in RMR studies. In addition, these results should not discourage overall water consumption for healthy functioning. Further, consumption of water-rich foods over time could be an effective strategy for weight management (as shown in other studies). Future studies could attempt to determine if larger volumes of water or different temperatures of water have an effect on RMR.

Renal replacement therapy, in the form of dialysis or transplantation, is the cornerstone of management for end-stage renal disease. UK renal registry shows nearly half of those needing renal replacement therapy are treated by dialysis – predominantly by haemodialysis. Patients on renal replacement therapy have increased mortality risk compared to age matched general population. Moreover, some specific subgroups of patients on haemodialysis have increased risk of mortality than expected. The survival benefit seen in women in the general population is attenuated resulting in similar survival for men and women on haemodialysis therapy. In addition, obese individuals and those of non-Caucasian origin have better survival outcome. Though the underlying reason for these findings is not clear and is likely to be multi-factorial, it has been hypothesised that this paradox could be due to the current practice of normalising dialysis dose to total body water. A number of metabolic factors – body surface area, resting energy expenditure and total energy expenditure – have been proposed as alternative to total body water for scaling dialysis dose. There were two overarching aims of this work – one was to study the effect of declining renal function on resting and total energy expenditure and to study the influence of various energy expenditure measures on uraemic toxin generation. The second was to study the impact on survival outcome of using these alternate parameters for normalising dialysis dose and to derive dialysis dose adjustments based on these metabolic parameters. In order to study these aims, studies were designed to explore different aspects of energy expenditure measures along with a longitudinal study to examine the impact of these parameters on survival outcome. The relationship between energy metabolism, body composition and uraemic toxin generation was studied with a retrospective analysis of 166 haemodialysis patients in whom urea generation rate was used as surrogate marker of uraemic toxin generation. It was found that total energy expenditure and fat-free mass predicted uraemic toxin generation after adjustment for other relevant variables. This study provided the preliminary data which was useful in designing further studies for this work. The effect of renal function on resting and total energy expenditure was studied in 80 patients with varying stages of chronic kidney disease who were not on renal replacement therapy. Resting and total energy expenditures were measured directly using gold-standard methods. It was found that declining renal function did not have a significant influence on either of these measures. This supports the hypothesis that metabolic rate is the driving force for glomerular filtration rate and not vice-versa. The directly measured energy expenditure measures were also found to have a moderately strong relationship with urea generation rate in these patients not on renal replacement therapy. The impact of physical activity on uraemic toxin generation, and thereby dialysis requirement, was studied in a prospective cross-sectional study of 120 haemodialysis patients in whom the physical activity was measured by an accelerometer device. Results from the study showed physical activity level to be a significant predictor of uraemic toxin generation after adjustment for gender and body size differences. This study results stressed the importance of adjusting dialysis dose based on individual’s physical activity level. To study the impact of using metabolic factors as normalising parameter for scaling dialysis dose on survival outcome, a large-scale longitudinal study was conducted with 1500 maintenance haemodialysis patients recruited for the study. Dialysis dose-related parameters and survival outcomes were collected at baseline and at various time points during the follow-up period of 18 months. Study results were analysed in two parts - the theoretical basis for using these metabolic factors as scaling parameters was explored which showed that current minimum target dialysis dose risks under-dialysis in certain subgroups of patients and using these alternative parameters may provide a more equivalent dialysis dose across individuals of different body sizes and gender. With these results arguing for potential use of the alternative parameters, the impact on survival of using them were examined. It was found that all three parameters performed better than the current parameter (total body water) with regards to predicting mortality. Total energy expenditure was found to be the best parameter with the lowest hazard ratio for risk of death. The study data was also analysed to derive an algorithm for adjustment of minimum target dialysis dose based on body size and physical activity level. This newly derived minimum dose target was also shown to impact on survival with those underdialysed based on this criteria having poorer survival outcomes. To understand the impact of whole body protein turnover on resting energy expenditure and uraemic toxin generation, a cross-sectional study was conducted on 12 patients with advanced CKD – 6 each in pre-dialysis CKD and haemodialysis group. It was found that haemodialysis patients had higher rate of protein turnover compared to pre-dialysis patients. Whole body protein turnover was found to contribute significantly to resting energy expenditure and had a moderately strong relationship with urea generation rate. In the course of these studies, two questionnaire tools have been validated for use for clinical and research purposes – one is a self-report comorbidity questionnaire and the other, the Recent Physical Activity Questionnaire. The comorbidity questionnaire was developed as part of this work and was validated against Charlson Comorbidity Index. The Recent Physical Activity Questionnaire was validated for physical activity data collection and energy expenditure calculation against the gold-standard doubly labelled water method. In conclusion, it has been demonstrated that metabolic factors such as body surface area, resting energy expenditure and total energy expenditure are more closely related to uraemic toxin generation compared to total body water. It has also been demonstrated that physical activity contributes to metabolic waste production and may necessitate changes in dialysis requirement. It has been shown that these metabolic factors, when used as scaling parameter for dialysis dosing, may predict survival better than the current parameter in use. The algorithm for dialysis dose adjustment and the questionnaires validated in this work have provided novel tools for further research studies and clinical practice. The central hypothesis of this work is that some metabolic factors may be better markers of uraemic toxin generation compared to total body water. It is hypothesised that modifications in dialysis practice based on these factors may improve the quality of haemodialysis and favourably impact on survival outcome for patients with end-stage renal disease. The work presented here largely supports this hypothesis.

Bakgrund Barn med fetma har lägre fysisk aktivitetsnivå än normalviktiga barn. Låga nivåer av fysisk aktivitet vid ung ålder leder ofta till låga nivåer av fysisk aktivitet som vuxen, vilket ger ökad risk för metabola syndromet. Ökad fysisk aktivitet ger ökad AEE och kan leda till ökad FFM, vilket hjälper till att höja TEE som är viktigt vid långsiktig viktminskning. Syfte Syftet med studien var att undersöka skillnad i total energiförbrukning, TEE, och aktivitetsrelaterad energiförbrukning, AEE, uppmätt med accelerometer på barn med övervikt eller fetma vid inskrivning, jämfört med efter minst ett år. Syftet var också att se om det var någon skillnad inom respektive kön i total och aktivitetsrelaterad energiförbrukning samt om det fanns något samband mellan dessa med förändring i kroppssammansättningen. Metod Data från två undersökningstillfällen där 28 barn genomfört mätning av BMR, kroppssammansättning och aktivitetsutredning med accelerometer samlades in. Jämförande statistik mellan undersökningstillfällena genomfördes på energiförbrukningsvariablerna TEE och AEE. Resultat TEE hade minskat (p=<0.01) och AEE hade minskat (p=<0.01) vid årskontrollen. Resultatet för respektive kön visade för pojkar att det var en skillnad mellan undersökningstillfällena i både TEE (p=0.004) och AEE (p=0.009). För flickor var det en skillnad i TEE (p=0.005) men inte i AEE (p=0.091). Det fanns en korrelation mellan TEE och FM (r=-0,47, p=0,014), och FFM (r=0,47, p=0.014) i procent. Slutsats Barnen i denna studie hade lägre TEE och AEE ett år efter de blivit inskrivna på överviktsenhet samtidigt som de blivit mer överviktiga. Med tanke på studiegruppens storlek bör detta resultat tolkas med försiktighet. / Background Children with obesity have a lower level of physical activity than normal weight children. Low levels of physical activity at a young age suggests low levels of physical activity as an adult, which increases the risk of the metabolic syndrome. Increased physical activity increases AEE and can lead to increased FFM which helps to increase TEE which is important for long term weight loss. Aim The aim of this study was to examine difference in total energy expenditure, TEE, and activity-related energy expenditure, AEE, measured by accelerometer on children with obesity at enrolment, compared to at least a year later. Furthermore, the aim was to see if there was any difference within each gender in total and activity-related energy expenditure and if there was any correlation between these with the change in the body composition. Method Data from two examinations where 28 children completed measurements of BMR, body composition, and activity registration with accelerometer was collected. Comparative statistics between the examinations were carried out on the energy consumption variables TEE and AEE. Results TEE has decreased (p=<0.01) and AEE has decreased (p=<0.01) at the year follow up. The result for each gender showed for the boys that there was a difference between the examinations in both TEE (p=0.004) and AEE (p=0.009). While for girls there was a difference in TEE (p=0.005) but not in AEE (p=0.091). There was a correlation between TEE and FM (r=-0.47, p=0.014), and FFM (r=0.47, p=0.014) in percent. Conclusion The children in this study had lower TEE and lower AEE one year after they were enrolled at the obesity unit while they have become more obese. Considering the size of the study group this result should be interpreted with caution.

Title: Effect of Arm Work Intensity on Energy Expenditure in Nordic Walking. Objectives: The aim of study is to assess energy expenditure of walking, Nordic Walking with low and high intensity of arm work. Methods: We tested 14 men in averge age 24,1 ± 1,8 years, body mass 74,3 ± 6,4 kg and height 179,1 ± 5,4 cm on laboratory treadmill. We used indirect calorimetry for assess energy expenditure influnced by intensity of arm work and different slopes. Descriptive statistics was used for basic evaluation. Analysis of varince with repeated measures (2x3) was used to assess statistical differences. The significance level was set at alfa ≤ 0,05. Results: We observed significant increase in the energy expenditure of Nordic Walking with high intensity in slopes 0 % and 10 % (39,60 ± 3,65 kJ.min-1 ; 58,79 ± 4,63 kJ.min-1 ) of arm work compared with Nordic Walking with low intensity of arm work (33,32 ± 3,64 kJ.min-1 ; 53,52 ± 4,78 kJ.min-1 ) and walking (31,26 ± 2,71 kJ.min-1 ; 52,66 ± 3,81 kJ.min-1 ). Increasing the energy expenditure of Nordic Walking with low intensity of arm work (33,32 ± 3,64 kJ.min-1 ; 53,52 ± 4,78 kJ.min-1 ) compared with walking (31,26 ± 2,71 kJ.min-1 ; 52,66 ± 3,81 kJ.min-1 ) in slopes 0 % and 10% did not reach significant difference. There was a significant increase in all...

The aim of this thesis was to determine the effect of driving in a wheelchair and walking on crutches on the energy expenditure and cardiopulmonary system in people with lower limb amputation. For this measurement we used a device Metamax 3B made by Cortex, functioning by measuring the concentration of oxygen and carbon dioxide in the breathing air, and a sporttester made by Polar. On the basis of oxygen consumption is possible to determine an energy expenditure during the activity. Our study was attended by 11 probands (men), patient of long-term hospital in Motol Hospital. Nine probands were amputated from vascular causes, one from the traumatological causes and one from the other causes. Probands rode (or walked) for four minutes back and forth along the corridor thirty meters long. They were instructed to ride (walk) at a speed to fit their needstand to also keep the same pace for a defined period of time. Walking on crutches without prosthesis managed only three of the testing file. During the study, these values were measured: distance traveled, average speed, oxygen consumption (VO2, VO2/kg, VO2 peak), carbon dioxide output (VCO2), respiratory exchange ratio (RER), tidal volume (VT), breathing frequention (BF), minute ventilation (MV), heart rate (HR), energy expenditure and performance. In this work...

Orientador: Vilmar Baldissera / Resumo: Apesar de diversos avanços científicos, mesmo após mais de 200 anos de aplicação da primeira calorimetria com humanos e todas as possibilidades criadas pelas tecnologias desenvolvidas, em especial os aparatos portáteis, o gasto energético (GE) dos exercícios resistidos ainda permanece, de certa forma, elusivo. Desta forma, o presente estudo foi conduzido com o objetivo geral de Quantificar e criar um modelo matemático para a predição do gasto energético de homens e mulheres jovens fisicamente ativos nos exercícios supino reto (SR) e leg press (LP). 11 homens (grupo masculino – GM), com idade (média ± desvio padrão) de 28,7 ± 5,5 anos, altura de 1,77 ± 0,07m, massa corporal de 81,40 ± 8,17kg e percentual de gordura de 16,36 ± 6,79% e 11 mulheres (grupo feminino – GF), com idade de 27,6 ± 4,6 anos, altura de 1,67 ± 0,06m, massa corporal de 60,05 ± 5,76kg e percentual de gordura de 20,20 ± 2,73% se voluntariaram para o estudo. Cada voluntário se apresentou ao Laboratório de Fisiologia do Exercício da UFSCar em oito ocasiões: na primeira visita, os voluntários foram informados sobre os objetivos e procedimentos do estudo, assinaram o termo de consentimento livre e esclarecido, os dados antropométricos mensurados e realizado o ajuste da biomecânica dos exercícios e teste de 1 repetição máxima (1RM) nos exercícios SR e LP. Após 48 a 72 horas, na segunda visita, os voluntários foram submetidos ao reteste de 1RM. Nas seis visitas seguintes, os voluntários foram submetidos ao protocol... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Despite many scientific advances, even after over 200 years of the first calorimetry on humans and all the possibilities made especially by portable apparatus, energy expenditure (EE) still remains somehow elusive. In this sense, the present study was conducted to quantify and create a model to predict EE of young physically active men and women on the bench press (BP) and leg press (LP) exercises. 11 men (male group – GM) with age (mean ± standard deviation) 27.8 ± 5.5 years, height 1.77 ± 0.07m, body mass 81.40 ± 8.17kg and body fat percentage of 16.36 ± 6.79% and 11 women (female group – GF) with age 27.6 ± 4.6 years, height 1.67 ± 0.06m, body mass 60.05 ± 5.76kg and body fat percentage of 20.20 ± 2.73% volunteered for the study. Volunteers came to the Exercise Physiology Laboratory of UFSCar on eight visits: in the first visit, volunteers were informed of the aims and proceedings of the study, signed an informed consent and had their anthropometric data analyzed, biomechanical adjustments made and perform 1 repetition maximum (1RM) test on both exercises. After 48 to 72 hours, volunteers came to the second visit to perform 1RM re-test. In the six following visits, volunteers were submitted to the EE protocol at 40, 60 or 80% of their 1RM on the BP and LP exercises. Interval for evaluations of the same exercise were 48 to 72 hours. GM had a significant difference in total energy expenditure between exercises, but such effect was not observed when EE was quantified as calor... (Complete abstract click electronic access below) / Doutor

Avaliou-se o balanço energético de 386 funcionários horistas produtivos, distribuídos por 12 funções de uma indústria automobilística do Estado de são Paulo. O dispêndio energético extra laborativo e o consumo alimentar foi estabelecido por meio de inquérito recordatório, de atividades e alimentar. O gasto, exclusivamente laborativo, foi determinado através do consumo de oxigênio pelo método de Douglas-Haldane em 30 funcionários. São apresentados dados sobre a forma como o empregado distribui seu tempo, assim como o consumo energético exclusivamente laborativo de cada função. O conteúdo calórico do café da manhã, do almoço e do jantar é discutido. O balanço calórico extra laborativo encontrado foi de 111,64 por cento e o laborativo foi de 89,14. Conclui que a relação entre o gasto energético e a reposição calórica pelos alimentos em termos diários globais para a população e época pesquisadas foi de 101,43, estando, portanto; em equilíbrio. / The energy balance of 386 hourly employed workers distributed in twelve functions in an automobile industry in the State of São Paulo, Brazil, was evalueted. The leisure energy expenditure and the food intake were established through the 24 hr recall as regards activities and foods. The energy expenditure was measured through oxygen intake by the Douglas-Haldane method in 30 employees. Data is presented as regards the way in which the employees spend their time as well as energy expenditure in each function. The caloric content of breakfast, lunch and dinner are discussed. The leisure caloric balance was 111,64 per cent and the work time caloric balance was 89,14. It is concluded that the ratio between energy expenditure and caloric replacement by food in a general day, for the population and time researched was 101,43, being , therefore, in energy balance.

Sabe-se que as diferentes respostas metabólicas advindas da realização de um exercício físico são influenciadas por fatores como idade, gênero, estado nutricional, assim como pelas próprias variáveis do exercício físico, em especial a intensidade e duração. Embora estas últimas variáveis sejam bastante estudadas, há uma lacuna na literatura sobre o comportamento do consumo de oxigênio (\'VO IND.2\'), gasto energético e lactacidemia quando diferentes exercícios são realizados na intensidade do limiar anaeróbio (AT). Além disso, não há relatos sobre uma possível fase estável do lactato em exercício resistido. Desta forma, a proposta deste estudo foi primeiramente verificar a possibilidade de identificação do AT em oito exercícios resistidos e posteriormente analisar o \'VO IND.2\', gasto energético e lactacidemia durante e após os exercícios em esteira, circuito, circuito/esteira e esteira/circuito, ambos realizados na intensidade do AT e com similar duração de execução de movimento. Para tanto, foram avaliados oito indivíduos do gênero feminino, saudáveis e fisicamente ativas, submetidas aos testes de determinação de uma repetição máxima (1RM), identificação do AT em oito exercícios resistidos, identificação do AT no exercício em esteira e realização dos protocolos de exercícios em esteira, circuito, circuito/esteira e esteira/circuito. Os resultados demonstraram a possibilidade de identificação do AT em todos os exercícios propostos. Durante o exercício, as variáveis metabólicas (\'VO IND.2\' e gasto energético) no exercício em esteira foram significativamente maiores quando comparadas aos exercícios em circuito, circuito/esteira e esteira/circuito. Nenhuma diferença significante foi constatada entre os protocolos circuito/esteira e esteira/circuito, para ambas as variáveis mencionadas. Já o exercício em circuito mostrou ser estatisticamente menor que os demais protocolos. No componente rápido do excess postexercise oxygen consumption (EPOC), o \'VO IND.2\' e gasto energético no exercício em esteira foram significativamente diferentes dos exercícios em circuito e em esteira/circuito. O exercício em circuito mostrou ser estatisticamente diferente do circuito/esteira, assim como também foi verificada uma diferença entre os protocolos mistos, para \'VO IND.2\' e gasto energético (p < 0,05). A duração e magnitude do \'VO IND.2\' no componente lento do EPOC não foram estatisticamente diferentes entre os protocolos, porém uma diferença foi constatada (p < 0,05) na magnitude da produção calórica entre os protocolos esteira e esteira/circuito, neste mesmo período de tempo. Nossos resultados não encontraram nenhuma diferença na duração total do EPOC entre os protocolos estudados. Ao computar o gasto energético total da sessão, somente o exercício em circuito apresentou um dispêndio significativamente maior em relação às calorias dispendidas apenas durante a realização deste exercício. Em relação à lactacidemia, foi possível identificar uma fase estável do lactato nos exercícios em esteira e em circuito. Conclusões: a realização de diferentes tipos de exercício exerce influência sobre o \'VO IND.2\' e gasto energético durante e após o exercício, ao passo que a ordem de execução dos mesmos em uma única sessão, para essas mesmas respostas metabólicas, só é influenciada no período pós-exercício. A duração total do EPOC independe da realização de diferentes tipos de exercícios, assim como da ordem de execução. Além disso, há a existência de uma fase estável do lactato em exercício resistido, quando realizado em forma de circuito. / It\'s known that differents metabolic responses that come from the practice of physical exercises are influenced by factors, such as age, gender, nutritional condition, as well as by their own exercise variable, in especially the intensity and duration. Although the latter variables are well studied, there is a gap in the literature about the behavior of oxygen consumption (\'VO IND.2\'), the energy expenditure and \"lactacidemia\" when different exercises are performed in the intensity of the anaerobic threshold (AT). In addition, there is no account about a possible stable phase of the lactate in a resistance exercise. This way, the proposal of this study was first to verify the possibility of identification of the AT in eight resistance exercises and then to analyze the \'VO IND.2\', the energy expenditure and the \"lactacidemia\" during and after the exercises at a treadmill, at a circuit, at a circuit/treadmill and at a treadmill/circuit, all done in the intensity of the AT and with similar duration of the movement execution. For this, eight female participants, healthy and physically active, were evaluated, submitted to tests of determination of a maximum repetition (1RM), identification of the AT in eight resistance exercises, identification of the AT in a treadmill exercise and the development of the protocols of exercise at a treadmill, at a circuit, at a circuit/treadmill and at a treadmill/circuit. The results demonstrated the possibility of identification of AT in all exercises. During exercise, the metabolic variables (\'VO IND.2\' and energy expenditure) in the exercise at the treadmill were significantly higher when compared to the exercises in circuit, circuit/treadmill and treadmill/circuit. No significant differences were found between the protocols circuit/treadmill and treadmill/circuit, for both variables mentioned. When it concerns the exercise in the circuit, it showed to be statistically lower than the other protocols. In the fast component of the excess postexercise oxygen consumption (EPOC), the \'VO IND.2\' and the energy expenditure at the treadmill exercise were significantly different when compared to the exercises at the circuit and at the treadmill/circuit. The exercise at the circuit was statistically different from the circuit/treadmill, and it was also verified a difference between the mixed protocols for the \'VO IND.2\' and the energy expenditure (p < 0,05). The duration and the magnitude of the \'VO IND.2\' in the slow component of the EPOC were not statistically different between the protocols, but there was a difference (p < 0,05) in the magnitude of the calorific production between the treadmill and the treadmill/circuit protocols. Our results didn\'t find any difference in the total duration of the EPOC in the protocols analyzed. When determining the total energy expenditure of the session, only the exercise at the circuit showed a significantly bigger energy expenditure in comparison with the expended calories just during the exercise. Concerning the \"lactacidemia\", it was possible to identify a stable phase of the lactate in the exercises at the treadmill and at the circuit. Conclusions: the performance of different types of exercise influences the \'VO IND.2\' and the energy expenditure during and after the exercise, while the order of the exercise practice in a single session, concerning the same metabolic answers, is just influenced in the period after the exercise. However, the total duration of the EPOC has nothing to do with the development of the different kinds of exercise, nor with the practice order. Besides, there is existence of a stable phase of the lactate in the resistance exercise, when performed in circuit.

Objectives: Negative energy balance can impair regeneration of the respiratory epithelium and limit the functionality of respiratory muscles, which can prolong mechanical ventilation. The present study sought to quantify and identify deviation in energy requirements of patients with septic shock during and upon liberation from mechanical ventilation. Methods: Patients admitted into intensive care with initial diagnosis of septic shock and mechanical ventilation-dependent were recruited. Their metabolic requirements before and after liberation from mechanical ventilation were measured by indirect calorimetry. Paired t-test was used to examine the variance between the two modes of breathing and Spearman rho correlation coefficient to examine relationship of selected indicators. Results: Thirty-five patients, 20 males and 15 females mean age 69 ±10 years, body height of 1.58 ±0.08 meters, and ideal body weight 59.01 ±7.63 kg were recruited. Median APACHEII score was 22, length of stay in the intensive care was 45 ±65 days and duration on mechanical ventilation was 24 ±25 days. Measured energy expenditure during ventilation was 2090 ±489 kcal∙d-1 upon liberation from ventilation was 1910 ±579 kcal∙d-1, and actual caloric intake was 1148 ±495 kcal∙d-1. Paired-t test showed that measured energy expenditure (p=0.02), actual calories provision and energy expenditure with (p=0.00) and without (p=0.00) ventilator support were all significantly different. Mean carbohydrate oxidation was 0.17 ±0.09 g·min-1 when patients were on mechanical ventilation compared to 0.14 ±0.08 g·min-1 upon liberalization from it, however, the results were not statistically significant. Furthermore, mean lipid oxidation was 0.08 ±0.05 g·min-1 during mechanical ventilation and 0.09±0.07 g·min-1 upon liberalization from it and the mean difference was not statistically significant. Spearman correlation coefficient showed a positive relationship between actual calorie provision and duration of stay in intensive care (r=0.41 and p=0.01) and duration on mechanical ventilation (r=0.55 and p=0.00). Oxygen consumption (r=0.49 and p=0.00) and carbon dioxide production (r=0.4 and p=0.02) were moderately strong and positive during and upon liberation from mechanical ventilation. Correlation between lipid oxidation and oxygen consumption during ventilation (r=0.74, p=0.00) and after ventilation (r=0.82, p=0.00) as well as lipid oxidation and carbon dioxide production during ventilation (r=0.37, p=0.03) and liberation from ventilator (r=0.91, p=0.00) were significantly correlated with each other in grams per minute only. Conclusions: This is a pioneering study to examine energy expenditure and substrate utilization and oxidation within a single cohort of patients. The lower measured energy expenditure upon liberation from mechanical ventilation among critically ill patients could result from positive pressure support from ventilation, the repeated cycle of “rest” and “work” during weaning from ventilators and the asynchronization between self-initiated breathing effort and the ventilatory support. The positive relationship in duration on mechanical ventilation and length of stay with calorie consumption could be longer stay led to more time for progression to reach nutrition targets. . Any discrepancy in energy expenditure and substrate utilization with and without ventilatory support should be monitored. Future studies are important to examine whether matching energy expenditure with energy intake could promote positive clinical outcomes.

Orientador: Daniela Ponce / Resumo: Introdução: A sepse caracteriza-se por intensa resposta inflamatória associada à infecção sistêmica, comumente acompanhada de Lesão Renal Aguda (LRA). A determinação do gasto energético de repouso (GER) em pacientes críticos é essencial para evitar complicações decorrentes da hipo e hiperalimentação. Objetivos: Ao estudar pacientes sépticos, este estudo tem como objetivos descrever o GER, analisar comparativamente o GER estimado pela equação de Harris-Benedict (HB) e o aferido pela calorimetria indireta (CI) e avaliar evolutivamente o GER. Métodos: Estudo tipo coorte prospectivo que avaliou pacientes admitidos em Unidade de Terapia Intensiva do HC-FMB, durante 18 meses consecutivos. Foram incluídos pacientes sépticos, maiores de 18 anos, admitidos em UTI e em ventilação mecânica, com e sem LRA definida pelos critérios do KDIGO. O GER foi estimado pela equação de HB e determinado pela CI até 72 horas após o diagnóstico de sepse e após sete dias da primeira aferição. Resultados foram expressos em média e desvio padrão ou mediana com intervalo interquartílico. Para a comparação entre variáveis categóricas utilizou-se o Teste Qui-Quadrado, entre variáveis continuas de distribuição normal o Teste T e na ausência de distribuição normal foi utilizado o Mann-Whitney, com p<0,05. A análise de regressão logística foi realizada pelo método de Stepwise, considerando p<0,1. Para a avaliação evolutiva do GER de toda a população e de acordo com a presença ou não de LRA foi utilizada análise... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Abstract Background: The determination of resting energy expenditure (REE) in critically ill patients is essential to prevent complications such as hypo and hyper alimentation. Objectives: This study aims to describe the REE in septic patients with and without acute kidney injury (AKI) and compare the REE estimated by the Harris-Benedict equation (HB) with the REE measured by indirect calorimetry (IC). Methods: Prospective and observational study was performed for 18 consecutive months. Septic patients older than 18 years, undergoing mechanical ventilation, with or without AKI defined by KDIGO criteria, and admitted to the Intensive Care Unit of University Hospital from Brazil were included. The REE was estimated by HB equation and measured by the IC within 72 hours after the diagnosis of sepsis and seven days after the initial measure. The chi-square test was used to compare categorical variables and t-test to compare parametric variables. For non-parametric variables, the Mann-Whitney test was used, p<0.05. Variables with significant univariate associations (p<0.10) were candidates for multivariable analysis, which was performed using stepwise variable selection. Repeated measures analysis using the mixed procedure was used for the evolutional REE. Results: Sixty-eight patients were evaluated, age was 62.49 ± 16.6 years, 64.7% were male, 63.2% had AKI, and SOFA was 9.81 ± 2.35. The measured REE was 1857.53 ± 685.32 kcal, while the estimated REE was 1514.87 ± 356.72 kc... (Complete abstract click electronic access below) / Mestre