Energy expenditure measured by indirect calorimetry in a neuroscience intensive care unit: a retrospective observational study
Underfeeding or overfeeding patients persist in intensive care units (ICU) worldwide. Among the key factors influencing the prevention of underfeeding and overfeeding in ICU is the precise determination of resting energy expenditure (REE). Indirect calorimetry (IC) improves the accuracy of nutritional assessment by providing real-time measurements based on the patient’s oxygen consumption and carbon dioxide production. While IC is considered the gold standard to determine REE in critically ill patients, predictive equations are commonly used instead due to the lack of resources.
Predictors of vitamin D status in undernourished and well-nourished children 6–59 months old, in the JB Marks Municipality of South Africa
Vitamin D deficiency/insufficiency is emerging as a widespread health concern in both healthy and undernourished children in Africa. A 25% vitamin D deficiency (VDD) prevalence has been reported in children across Africa. Similarly, in undernourished children, a 31% and 44% prevalence has been observed in Tanzania and Uganda, respectively. There is increasing evidence of the role of vitamin D (vitD) in immune function and infection prevention. Aside from impairment of skeletal growth, VDD in children may lead to increased susceptibility to infectious diseases, which is one of the leading causes of morbidity and mortality in children aged under five years. The literature suggests that vitD status is influenced by a number of factors, including but not limited to the level of sunshine exposure, dietary intake, genetic variations, season, and skin pigmentation.6–9 In South Africa (SA), Poopedi et al. observed the influence of season on vitD status in white but not black 10-year-old children, with 25- hydroxyvitamin D (25(OH)D) levels highest in summer and autumn.10 Vitamin D levels have also been reported to increase with age in a study involving Malawian infants from birth to 24 months. A number of studies in adults have associated VDD with elevated systemic and intestinal inflammation, which is common in undernourished children. However, in a study by Mogire et al. inflammation was associated with higher 25 (OH)D concentration in African children aged between 0 and 8 years. Vitamin D deficiency has been associated with iron deficiency (ID), as the latter is reported to inhibit the activity of the enzymes and 1α-hydroxylase involved in the metabolism of vitD. In South African children aged 6–59 months, little is known about the determining factors of vitD status and the factors contributing to VDD. Therefore, we aimed to describe the prevalence of VDD and insufficiency and investigate the predictors of vitD status among undernourished and well-nourished children aged under five years in a peri-urban area in SA.