Estimate of Daily Calorie Needs for a Neuromuscular Disease Patient Receiving Noninvasive Ventilation

Abstract

The purpose of this report is to estimate the daily caloric intake needed by a person with substantial muscle wasting due to neuromuscular disease and who also uses a ventilator for substantial amounts of time. Although this study was done for a particular individual, its methodology is generalized to any nonambulatory neuromuscular disease patient. The author, the person chosen for this analysis, is a male, limb girdle muscular dystrophy patient, who uses noninvasive ventilation approximately 20 hrs/day. An experimental technique gave a range of energy requirements for the study individual of total energy expenditure (TEE) of 788 kcal/day < or = TEE (experimental) < or = 876 kcal/day, or an average of 832 kcal/day, and the model developed here gave a range of 801 kcal/day < or = TEE (model) < or = 871 kcal/day, or an average of 836 kcal/day. This article examines and then generalizes these results to develop a simple equation that clinicians and nutritionists may use to estimate daily energy needs for ventilated neuromuscular disease patients. Because severe muscle wasting--which we define for the purposes of this article to be <30% of normal--is assumed, this analysis represents a near minimum daily energy need.