Time-course changes in energy expenditure in sepsis: a prospective observational study
Authors' conclusion
Energy metabolism in sepsis evolves dynamically, with significant changes in REE and substrate utilization over time. Temperature, acid-base balance, CRRT, and nutritional strategies were associated with variability in energy expenditure.
Study context
- Population
- Mechanically ventilated adults with sepsis
- Participants
- 30 participants
- Outcome
- Time-course changes in REE and RQ (indirect calorimetry) and their clinical and nutritional predictors
- Follow-up
- Days 1, 2, 3, 5 and 7 after diagnosis
Methodological detailslinear mixed-effects models
- Linear mixed-effects models
Main finding
As reported in the abstract
REE and RQ over time · Day 5 vs Day 1
- Resting energy expenditure (REE) increased by Day 5 vs Day 1 (kcal/day)
- + 163.7
- REE change Day 5 vs Day 1, p
- p = 0.049
- Concurrent rise in respiratory quotient (RQ), p
- p = 0.013
Observational data: associations, not effects.
Further findings
Predictors of REE
- Higher body temperature, higher arterial pH, greater protein-to-non-protein calorie ratio and higher protein intake associated with higher REE
- Higher lactate and use of CRRT associated with lower REE
Predictors of RQ
- RQ positively associated with energy intake, REE coverage and blood glucose
Clinical-severity scores and inflammatory markers
- No significant associations with REE or RQ
Original publication
Time-course changes in energy expenditure in sepsis: a prospective observational study. Ann Intensive Care. Published 14 October 2025. doi:10.
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