{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:44:25Z","timestamp":1760985865481},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T00:00:00Z","timestamp":1580688000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T00:00:00Z","timestamp":1580688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Both overfeeding and underfeeding of intensive care unit (ICU) patients are associated with worse outcomes. A reliable estimation of the energy expenditure (EE) of ICU patients may help to avoid these phenomena. Several factors that influence EE have been studied previously. However, the effect of neuromuscular blocking agents on EE, which conceptually would lower EE, has not been extensively investigated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We studied a cohort of adult critically ill patients requiring invasive mechanical ventilation and treatment with continuous infusion of cisatracurium for at least 12\u2009h. The study aimed to quantify the effect of cisatracurium infusion on EE (primary endpoint). EE was estimated based on ventilator-derived VCO<jats:sub>2<\/jats:sub> (EE in kcal\/day\u2009=\u2009VCO<jats:sub>2<\/jats:sub>\u2009\u00d7\u20098.19). A subgroup analysis of septic and non-septic patients was performed. Furthermore, the effects of body temperature and sepsis on EE were evaluated. A secondary endpoint was hypercaloric feeding (&gt;\u2009110% of EE) after cisatracurium infusion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, 122 patients were included. Mean EE before cisatracurium infusion was 1974\u2009kcal\/day and 1888\u2009kcal\/day after cisatracurium infusion. Multivariable analysis showed a significantly lower EE after cisatracurium infusion (MD \u2212\u2009132.0\u2009kcal (95% CI \u2212\u2009212.0 to \u2212\u200952.0; <jats:italic>p<\/jats:italic>\u2009=\u20090.001) in all patients. This difference was statistically significant in both sepsis and non-sepsis patients (<jats:italic>p<\/jats:italic>\u2009=\u20090.036 and <jats:italic>p<\/jats:italic>\u2009=\u20090.011). Non-sepsis patients had lower EE than sepsis patients (MD \u2212\u2009120.6\u2009kcal; 95% CI \u2212\u2009200.5 to \u2212\u200940.8, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). Body temperature and EE were positively correlated (Spearman\u2019s rho\u2009=\u20090.486, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Hypercaloric feeding was observed in 7 patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our data suggest that continuous infusion of cisatracurium in mechanically ventilated ICU patients is associated with a significant reduction in EE, although the magnitude of the effect is small. Sepsis and higher body temperature are associated with increased EE. Cisatracurium infusion is associated with overfeeding in only a minority of patients and therefore, in most patients, no reductions in caloric prescription are necessary.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13054-020-2744-7","type":"journal-article","created":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T16:03:42Z","timestamp":1580745822000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The effect of cisatracurium infusion on the energy expenditure of critically ill patients: an observational cohort study"],"prefix":"10.1186","volume":"24","author":[{"given":"W. A. C.","family":"Koekkoek","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y. A.","family":"Menger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. J. 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Inclusion fees for patients in nutrition trials were paid to the local ICU research foundation. The remaining authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"32"}}