Q-NRG+

The indirect calorimeter designed by clinicians for clinicians.

For critically ill patients who require nutritional support, Q-NRG+ offers quick and accurate resting energy expenditure (REE) measurement through indirect calorimetry (IC). International guidelines recommend use of indirect calorimetry to guide energy prescription to avoid under- and over- feeding.^1,2

Experience the Q-NRG+ Virtual 360 Demo

Energy requirements of critically ill patients are dynamic and vary by condition³

Predictive equations, while often used, are only accurate for up to 50% of critically ill patients and can lead to under- or over- feeding.⁴ Energy deficits are associated with increased mortality and morbidity including increased length of hospital stay, infections and prolonged mechanical ventilation.^5-8 Whereas overnutrition is associated with increased hyperglycemia, hepatic steatosis, and mortality.^8,9 Optimizing nutrition support may be difficult with the lack of insight into the variable energy needs of ICU patients.³

“The accuracy of predictive equations is very low. 
And  this could lead to overfeeding or underfeeding
the patient leading to increased mortality or morbidity.” 

Dr. Pierre Singer

Inaccuracy of predictive equations⁴

Graph — Adapted from Zusman O, et al. Clinical Nutrition 2019. *REE: Resting Energy Exependiture

Use of the gold standard, indirect calorimetry (IC), to measure caloric needs may improve outcomes^1,10-12

Accurate assessment of nutritional requirements for critically ill patients is at the core of nutritional support. In a 2021 meta-analysis, Duan et al. showed that IC-guided nutrition therapy significantly reduced short-term mortality.¹¹ Reaching energy targets guided by IC and provision of supplemental parenteral nutrition (SPN) demonstrated a reduction in hospital infection rates greater than 25%.⁵ Additionally, randomized control trials using SPN to cover energy needs measured by IC showed improvement in immunity or less systemic inflammation.¹³

Experience the Q-NRG+ Virtual 360 Demo

Learn how Q-NRG+ enables individualized resting energy expenditure measurements at the point of care.
This tool is best viewed on desktop or in landscape mode on mobile.

Fast and reliable measurements

Accurate measurement of resting energy expenditure in around 10-15 minutes up to 70% FiO2.

Portable and easy to use

User-friendly touch screen and battery-powered for easy transport in the hospital.

Seamless integration

Compatible with current nutrition therapy workflows and all ventilators, patient canopies or masks.

Minimal maintenance

Automatic daily and monthly calibrations for simple maintenance and operation.

The Clinical Value of Q-NRG+

Dr. Claude Pichard explains the benefits of using the Q-NRG+ indirect calorimeter for patient energy assessment

“I think we are now in a new period.  With [Q-NRG+] we are going
to be able to tailor the level of energy administration to our patient,
thereby optimize  the  nutrition prescription.”

Dr. Claude Pichard

Learn more about Q-NRG+

Visit the Clinical Nutrition Resource Library to access additional resources

Resource Library

Related Products

Important safety information

Q-NRG+ Indications for Use: This device is intended for the measurement of REE for spontaneously breathing and ventilated patients, with some limitations in accordance with labeling, within the following population: spontaneously breathing subjects >15 Kg (33 lb), when tested with the Canopy dilution technique, ventilated subjects >age 10 and >10 Kg (22 lb), and spontaneously breathing subjects > age 6 and >10 Kg (22 lb), when tested with Face Mask. This device is not suitable for operating in presence of flammable anesthetic gases or gases other than O2, CO2, N2 and water vapor. The device is to be used by physicians or by trained personnel under the responsibility of a physician. The device is not intended as a continuous monitoring device for surveillance of vital physiological processes.

Warnings: This device measures clinical parameters used to aid diagnosis and it is intended only as an adjunct device in patient assessment. In case of disturbing conditions, the shutdown is allowed because the safety of the device towards patients and operators is not affected, since the final evaluation is performed on the outcome data measured during a complete test. No modification of this device is allowed.

For the safe and proper use of the devices mentioned herein refer to the User Manual.

See References

McClave, S.A., et al., Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr, 2016. 40(2): p. 159-211.
Singer P, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr 2019;38:48-79
Rattanachaiwong, S. and P. Singer, Indirect calorimetry as point of care testing. Clin Nutr, 2019. 38(6): p. 2531-2544.
Zusman O, et al. Predictive equations versus measured energy expenditure by indirect calorimetry: A retrospective validation. Clin Nutr, 2019. 38(3): p. 1206-1210.
Heidegger C.P., et al. Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: a randomised controlled clinical trial. Lancet. 2013;381(9864):385-93.
Yeh D, et al. Adequate Nutrition May Get You Home: Effect of Caloric/Protein Deficits on the Discharge Destination of Critically Ill Surgical Patients. JPEN. 2016; 34:37–44.
Villet S, et al. Negative impact of hypocaloric feeding and energy balance on clinical outcome in ICU patients. Clinical Nutrition (2005) 24, 502–509.
Zusman, O., et al., Resting energy expenditure, calorie and protein consumption in critically ill patients: a retrospective cohort study. Crit Care, 2016. 20(1): p. 367.
Oshima, T. Et al. Indirect calorimetry in nutritional therapy. A position paper by the ICALIC study group. Clinical Nutrition, 2017 Jun;36(3):651-662.
Wichansawakun, S., et al., Energy requirements and the use of predictive equations versus indirect calorimetry in critically ill patients. Appl Physiol Nutr Metab, 2015. 40(2): p. 207-10.
Duan J, et al. Energy delivery guided by indirect calorimetry in critically ill patients: a systematic review and meta‑analysis. Crit Care (2021) 25:88.
Gonzalez-Granda A, et al. Optimization of Nutrition Therapy with the Use of Calorimetry to Determine and Control Energy Needs in Mechanically Ventilated Critically Ill Patients: The ONCA Study, a Randomized, Prospective Pilot Study. JPEN J Parenter Enteral Nutr. 2019 May;43(4):481-489.
Berger M, et al. Supplemental parenteral nutrition improves immunity with unchanged carbohydrate and protein metabolism in critically ill Q6 patients: The SPN2 randomized tracer study. Clin Nutr. 2019 Oct;38(5):2408-2416.

Therapies

Q-NRG+

Energy requirements of critically ill patients are dynamic and vary by condition³

Inaccuracy of predictive equations⁴

Use of the gold standard, indirect calorimetry (IC), to measure caloric needs may improve outcomes^1,10-12