Personalised energy targeting during venovenous extracorporeal membrane oxygenation (ECMO): serial assessment of resting energy expenditure reveals phase-dependent metabolic demand and systematic discordance with predictive equations
Authors' conclusion
Both actual feeding practice and standard predictive equations failed to match measured energy requirements regardless of body weight choice.
Study context
- Population
- Adults receiving venovenous ECMO for ARDS, Charité - Universitätsmedizin Berlin75 valid measurements
- Participants
- 9 adults
- Comparison
- Measured EE vs actual energy intake and vs ESPEN-guided prediction
- Primary endpoint
- Feeding equipoise (ratio of actual energy intake to measured EE; equipoise 80-110%)
Methodological detailssingle-centre, serial indirect calorimetry (MEEP protocol), discordance analysis
- Single-centre
- Serial indirect calorimetry (MEEP protocol)
- Discordance analysis
Primary result
As reported in the abstract
Median measured EE (IQR 1594-2222), kcal/day
1923
Feeding equipoise achieved, measurement days
30 of 75
40%
Overfed, % of days
44%
Underfed, % of days
16%
Further findings
ESPEN 25 kcal/kg/day vs measurement-based classification
- Adjusted body weight: misclassified feeding equipoise, % of days
- 55%
- Adjusted body weight: concordance
- 45%
- Actual body weight: concordance (sensitivity analysis)
- 49%
ECMO circuit share of total gas exchange
- Share of total gas exchange (mean ± SD 18.2%)
- 60.5%
Respiratory quotient
- Respiratory quotient (± 0.131)
- 0.908
- Correlation with feeding ratio (ρ), not correlated
- 0.024
Original publication
Personalised energy targeting during venovenous ECMO: serial assessment of resting energy expenditure reveals phase-dependent metabolic demand and systematic discordance with predictive equations. Crit Care. Published 16 September 2026. doi:10.
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