AzTrials
AzTrials

Pediatric Critical IllnessQ-NRG2025NCT07462806

Indirect Calorimetry Measurement in the Pediatric Intensive Care Unit's Smallest Patients

An observational study of Pediatric Critical Illness, run by Karolinska Institutet at 1 site in Sweden.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

Indirect calorimetry is considered the reference method for measuring energy expenditure in intensive care patients. However, in infants and small children weighing less than 10 kilograms, its clinical use has historically been limited due to technical challenges related to low tidal volumes, potential increases in… Read more about this study

Who is it for?
Any age
Conditions the study is for
Pediatric Critical Illness
What is being tested?
Q-NRG+
Type of treatment
Medical device
How many people
80 participants
Where
1 siteSweden
Study dates
Apr 2026to Dec 2027
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: The study population consists of critically ill infants and children weighing 0.5-10 kg who are admitted to a pediatric intensive care unit and require mechanical ventilation or are spontaneously breathing and eligible for indirect calorimetry measurement. Participants are recruited consecutively during the study period (Q2 2026-Q4 2027).

Who may be able to join

None listed.

Who cannot join

  • In mechanically ventilated patients' unstable ventilation including ventilation settings changed during the last 60 minutes (FiO2 >70%, PIP>30 cmH2O, or ventilation system leakage). Patients spontaneous breathing not tolerating measurements with canopy.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Mirjam Larsson, Ass Senior Consultant PhD stud contact

+46707474628

mirjam.m.larsson@regionstockholm.se

Urban Fläring, Ass prof, senior consultant contact

+46708763900

urban.flaring@ki.se

Sweden1 site
  • Pediatric Perioperative Medicine and Intensive Care Stockholm, Sweden

    Stockholm, Solna, 17176

    Urban Fläring, Ass prof, senior consultant, +46708763900, urban.flaring@ki.se

Other trials in Sweden

About this study

Official title: Indirect Calorimetry Measurement in the Paediatric Intensive Care Unit's Smallest Patients

Indirect calorimetry is considered the reference method for measuring energy expenditure in intensive care patients. However, in infants and small children weighing less than 10 kilograms, its clinical use has historically been limited due to technical challenges related to low tidal volumes, potential increases in dead space, and measurement precision.

The goal of this observational study is to evaluate the feasibility and performance of indirect calorimetry using the Q-NRG+ device in critically ill children weighing less than 10 kg who are admitted to a pediatric intensive care unit.

Read the detailed description

Indirect calorimetry measures oxygen consumption and carbon dioxide production to calculate resting energy expenditure and is considered the reference method in intensive care. In mechanically ventilated pediatric patients, resting energy expenditure is commonly used as a surrogate for total energy expenditure, as activity-related expenditure is minimal due to sedation and ventilation. Despite its clinical relevance, the use of indirect calorimetry in children weighing less than 10 kg has been limited by technical challenges related to low tidal volumes and measurement precision. The Q-NRG+ is an indirect calorimeter designed to measure resting energy expenditure in mechanically ventilated and spontaneously breathing patients.

This prospective, single-center observational study will be conducted in a pediatric intensive care unit. Critically ill children weighing less than 10 kg who require mechanical ventilation or are spontaneously breathing and able to tolerate indirect calorimetry measurement using a canopy hood will be eligible for inclusion. Indirect calorimetry measurements will be performed according to a predefined protocol during the course of critical illness. For the measurement, a sampling module will be connected to the ventilator circuit without increasing ventilator dead space. The system continuously samples inspired and expired gases, and energy expenditure is calculated based on measured oxygen consumption and carbon dioxide production in combination with ventilator parameters.

The primary objective is to evaluate the feasibility of indirect calorimetry using the Q-NRG+ in critically ill children weighing less than 10 kg, defined as the proportion of technically valid and clinically interpretable measurements. Secondary objectives are to describe measured resting energy expenditure (kcal/kg/day) in this population, to evaluate changes in measured energy expenditure over the course of critical illness, and to compare measured energy expenditure with predicted energy requirements calculated using standard predictive equations. Demographic and clinical variables relevant to metabolic status (age, weight, diagnosis, ventilator settings, sedation, and phase of illness) will be collected from medical records. Descriptive and comparative statistical analyses will be performed.

Being tested
Q-NRG+
Keywords
Pediatric Critical Illness, weight under 10 kilogram, Indirect calorimetry, Energy expenditure, Nutritional assessment, Q-NRG+, Pediatric intensive care, chofield equation, Metabolic monitoring

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Q-NRG+Device

    The Q-NRG+ is an indirect calorimetry device used to measure resting energy expenditure in mechanically ventilated or spontaneously breathing patients. In this study, the device is connected to the ventilator circuit or used with a canopy hood to measure oxygen consumption and carbon dioxide production for calculation of energy expenditure. Measurements are performed in addition to standard clinical care and do not alter routine treatment.

Study groups in NCT07462806
Study groupRoleWhat they receive
Critically ill children with weight under 10 kilograms undergoing indirect calorimetryThis cohort includes critically ill children weighing less than 10 kilograms who are admitted to a pediatric intensive care unit. Participants undergo indirect calorimetry measurements using the Q-NRG+ device in addition to standard clinical care. Measured energy expenditure is recorded and analyzed without altering routine treatment.
Receives: Device: Q-NRG+

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Feasibility of Q-NRG+ indirect calorimetry measurements

    Feasibility is defined as the proportion of attempted Q-NRG+ measurements in infants weighing 0.5-10 kg that result in technically valid and clinically interpretable data according to predefined quality criteria (i) variability <10% over a 15-minute period with constant Vt/MV (tidal volume/minute ventilation) and (ii) respiratory Quotient (RQ) within the range of </=1 or >/=0.7.

    Measured: From first enrollment until end of study (During PICU stay (Q2 2026 - Q4 2027)

Secondary outcomes (5)
  1. Agreement between carbon dioxide production measured by Q-NRG+ and volumetric capnography, Capnostat 5

    Comparison of carbon dioxide production measured using the Q-NRG+ device with obtained via other volumetric capnography already used in the clinic when available.

    Measured: During PICU stay (Day 1 to Day 7), when simultaneous Q-NRG+ and Capnostat 5 measurements are available (up to 5 measurements per patient).

  2. Agreement between measured resting energy expenditure and predicted through Schofield equation.

    Comparison between resting energy expenditure measured by Q-NRG+ and estimated using the Schofield equation, commonly used in peadiatric intensive care units.

    Measured: During PICU stay, at each Q-NRG+ measurement (up to 5 measurements per patient).

  3. Change in measured resting energy expenditure across phases of critical illness.

    Evaluation of variation in measured REE during acute, stable, and recovery phases of critical illness.

    Measured: Daily during PICU stay, up to 5 Q-NRG+ measurements per patient.

  4. Agreement between oxygen consumtion and carbondioxid production derived from blood gas respiratory quotient and Q-NRG+ measurements

    Comparison between oxygen consumtion and carbondioxid production calculated from blood gas central venous and arteriall and measured using Q-NRG+.

    Measured: Measurements will be collected from the time of first enrollment until the end of the study (Q2 2026 - Q4 2027).

  5. Development of predictive model for resting energy expenditure in critically ill children under 10 kilograms.

    Exploratory analysis to develop predictive equations for REE based on repeated Q-NRG+ measurements.

    Measured: During PICU stay, based on repeated Q-NRG+ measurements (up to 5 measurements per patient).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Mar 2026
  2. Study startApr 2026 (estimated)
  3. Primary completionApr 2027 (estimated)
  4. Study completionDec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07462806
Sponsor's protocol ID
K 2025-0683
Acronym
Q-NRG2025
Status last verified
Mar 2026
First submitted
2 Mar 2026
Last updated
10 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Flaring U, Finkel Y. Nutritional support to patients within the pediatric intensive setting. Paediatr Anaesth. 2009 Apr;19(4):300-12. doi: 10.1111/j.1460-9592.2009.02954.x. No abstract available.

    PubMed 19335343
  • Tume LN, Valla FV, Joosten K, Jotterand Chaparro C, Latten L, Marino LV, Macleod I, Moullet C, Pathan N, Rooze S, van Rosmalen J, Verbruggen SCAT. Nutritional support for children during critical illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations. Intensive Care Med. 2020 Mar;46(3):411-425. doi: 10.1007/s00134-019-05922-5. Epub 2020 Feb 20.

    PubMed 32077997
  • Mehta NM, Skillman HE, Irving SY, Coss-Bu JA, Vermilyea S, Farrington EA, McKeever L, Hall AM, Goday PS, Braunschweig C. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2017 Jul;41(5):706-742. doi: 10.1177/0148607117711387. Epub 2017 Jun 2.

    PubMed 28686844
  • Karlsson J, Svedmyr A, Wallin M, Hallback M, Lonnqvist PA. Validation of an alternative technique for RQ estimation in anesthetized pigs. Intensive Care Med Exp. 2024 Jan 25;12(1):11. doi: 10.1186/s40635-024-00598-8.

    PubMed 38270695
  • Joosten KFM, Eveleens RD, Verbruggen SCAT. Nutritional support in the recovery phase of critically ill children. Curr Opin Clin Nutr Metab Care. 2019 Mar;22(2):152-158. doi: 10.1097/MCO.0000000000000549.

    PubMed 30585805
  • Joosten KF, Kerklaan D, Verbruggen SC. Nutritional support and the role of the stress response in critically ill children. Curr Opin Clin Nutr Metab Care. 2016 May;19(3):226-33. doi: 10.1097/MCO.0000000000000268.

    PubMed 26963579
  • Hulst JM, van Goudoever JB, Zimmermann LJ, Hop WC, Buller HA, Tibboel D, Joosten KF. Adequate feeding and the usefulness of the respiratory quotient in critically ill children. Nutrition. 2005 Feb;21(2):192-8. doi: 10.1016/j.nut.2004.05.020.

    PubMed 15723748
  • Gunst J, Vanhorebeek I, Verbruggen SC, Dulfer K, Joosten KF, Van den Berghe G. On how to feed critically ill children in intensive care: A slowly shifting paradigm. Clin Nutr. 2025 Mar;46:169-180. doi: 10.1016/j.clnu.2025.02.003. Epub 2025 Feb 6.

    PubMed 39947042
  • Fell DM, Bitetto EA, Skillman HE. Timing of enteral nutrition and parenteral nutrition in the PICU. Nutr Clin Pract. 2023 Oct;38 Suppl 2:S174-S212. doi: 10.1002/ncp.11050.

    PubMed 37721466
  • Fadeur M, Kaux JF, De Flines J, Misset B, Paquot N, Rousseau AF. Indirect calorimetry in canopy mode in healthy subjects: performances of the Q-NRG device compared to the Deltatrac II. Acta Gastroenterol Belg. 2025 Jan-Mar;88(1):13-17. doi: 10.51821/88.1.13301.

    PubMed 39961294
  • Briassoulis G, Briassouli E, Ilia S, Briassoulis P. External Validation of Equations to Estimate Resting Energy Expenditure in Critically Ill Children and Adolescents with and without Malnutrition: A Cross-Sectional Study. Nutrients. 2022 Oct 6;14(19):4149. doi: 10.3390/nu14194149.

    PubMed 36235803
  • Alcantara JMA, Galgani JE, Jurado-Fasoli L, Dote-Montero M, Merchan-Ramirez E, Ravussin E, Ruiz JR, Sanchez-Delgado G. Validity of four commercially available metabolic carts for assessing resting metabolic rate and respiratory exchange ratio in non-ventilated humans. Clin Nutr. 2022 Mar;41(3):746-754. doi: 10.1016/j.clnu.2022.01.031. Epub 2022 Feb 4.

    PubMed 35180452
  • Albert BD, Spolidoro GC, Mehta NM. Metabolism and energy prescription in critically ill children. Minerva Anestesiol. 2021 Sep;87(9):1025-1033. doi: 10.23736/S0375-9393.21.14825-4. Epub 2021 Apr 14.

    PubMed 33853268
  • Albert BD, Martinez EE. Challenges and advances in nutrition for the critically ill child. Curr Opin Crit Care. 2022 Aug 1;28(4):401-408. doi: 10.1097/MCC.0000000000000953. Epub 2022 Jul 5.

    PubMed 35797542

Questions about this trial

What is this clinical trial studying?

An observational study of Pediatric Critical Illness, run by Karolinska Institutet at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 0 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 10 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Mirjam Larsson, Ass Senior Consultant PhD stud (+46707474628, mirjam.m.larsson@regionstockholm.se), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Feasibility of Q-NRG+ indirect calorimetry measurements (time frame: From first enrollment until end of study (During PICU stay (Q2 2026 - Q4 2027)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07462806, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Mar 2026; AzTrials last refreshed its copy on 8 Nov 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in