Resting Metabolic Rate/Indirect Calorimetry Report

Patient: [Full name or [[Name missing]]]; MRN: [MRN or [[MRN missing]]]; DOB: [DOB or [[DOB missing]]]; Sex: [Sex or [[Sex missing]]]

Test Date/Time: [Date and time or [[Date/Time missing]]] — Location: [Facility/Unit/Room or [[Location missing]]]

Ordering Clinician: [Name, credentials or [[Ordering clinician missing]]] | Performing Clinician: [Name, credentials or [[Performing clinician missing]]] | Interpreting Clinician: [Name, credentials / Same as performing / [[Interpreting clinician missing]]]

Clinical Indication

• [Primary indication(s) for testing: weight management / malnutrition assessment / bariatric pre-op / sports nutrition / ventilator weaning / other]
• [Referral question] (Include only if explicitly stated.)
• [Pertinent conditions affecting metabolic interpretation: thyroid disease, fever, active infection, recent trauma/surgery, pregnancy, burns, sepsis, organ failure] (Include only conditions relevant to metabolism.)

(If no clear indication documented, state: "No explicit clinical indication documented; results reported without strong recommendations.")

Pre-Test Conditions

(Document succinctly; label unknown items as "Unknown" rather than inferring.)

• Fasting status: [Fasted # hours / Non-fasted, # hours since last caloric intake / Unknown] (If non-fasted, label result as non-fasted REE.)
• Rest period and position: [# minutes resting] in [supine / reclined / seated] prior to measurement
• Stimulants: Caffeine [# hours prior / Unknown]; Nicotine [# hours prior / Unknown]
• Exercise: [# hours since last moderate/vigorous activity / Unknown]
• Medications affecting metabolic rate or gas exchange: [List relevant meds / None reported / Unknown]
• Room conditions: [Quiet / Not quiet], [Dim / Bright], [Thermoneutral / Not thermoneutral]; [Notable exceptions]
• Protocol deviations: [None / Brief description of deviations]

Test Method

• Measurement modality: [Canopy/Hood / Mouthpiece / Mask / Ventilator-integrated module]
• Device: [Make/Model]
• Calibration: [Performed / Not performed]
• Total collection duration: [# minutes]; Duration analyzed: [# minutes]
• Stabilization period excluded: [Yes, first # minutes excluded / No]
• Steady-state criteria used: [Explicit definition, e.g., "≥5-minute window with VO₂ and VCO₂ CV <10%"]

(Include the following fields only for mechanically ventilated patients.)

• Ventilator settings: Mode [Mode]; FiO₂ [%]; PEEP [cmH₂O]
• Leak assessment: [No significant leak detected / Suspected leak / Unknown]
• Extracorporeal support: [ECMO present, type / CRRT present / None]

Measurement Quality

• Steady state achieved: [Yes / No / Partially]
• Variability: VO₂ CV [%]; VCO₂ CV [%] (If available.)
• RQ plausibility: [RQ value] — [Within expected range 0.70–1.00 / Outside expected range; potential cause]
• Artifacts/leaks: [None observed / Talking / Coughing / Movement / Sensor error / Ventilator leak / Other]
• Overall validity classification: [Valid for interpretation / Borderline—interpret with caution / Invalid—do not use for prescription] — [Brief reason]

Quality summary: [One-sentence summary, e.g., "Steady state achieved; variability acceptable; results valid for clinical use."]

Results

Parameter	Value	Notes
VO₂	[mL/min]
VCO₂	[mL/min]
RQ (VCO₂/VO₂)	[Value]	[Plausibility notes if needed]
Measured REE	[kcal/day]	[Label as non-fasted REE if applicable]
Weight used	[Actual / Ideal / Adjusted / Dry] — [kg]	[Measured / Self-reported]
REE per kg	[kcal/kg/day]
Minute ventilation	[L/min]	(If provided by device.)
Resting heart rate	[bpm]	(If monitored.)

(Include predicted comparison if clinically relevant.)

Predictive Equation	Inputs	Predicted REE	Measured vs Predicted
[Mifflin-St Jeor / Harris-Benedict / Penn State / Other]	Age [years]; Sex [M/F]; Height [cm]; Weight [type, value] (Label self-reported values.)	[kcal/day]	[±kcal/day]; [% of predicted]

Interpretation

Bottom line: Measured REE is [value] kcal/day under resting conditions.

[Metabolic phenotype comment if valid and clinically relevant, e.g., "Measured REE is approximately [±%] [above/below] predicted, which may reflect [brief, cautious explanation] in the current clinical context."] (Omit if not clinically meaningful.)

[RQ interpretation] (Include only if measurement quality supports it; prioritize quality explanations over nutritional inferences if RQ is out of range.)

Limitations: [Protocol deviations, unknown pre-test conditions, quality concerns, calibration issues, ventilator leaks, extracorporeal support, or "None significant."]

(If validity is borderline or invalid: "Repeat testing recommended under the following conditions: [specify]. Clinical recommendations should be considered provisional.")

Caloric Target Recommendations

(Include only when nutrition prescription or counseling is part of the encounter.)

• REE used for planning: [Measured REE (valid) / Estimated REE via [equation] due to [reason measured not used]]
• Approach to total energy target: [Ambulatory: activity factor or PAL [value/range] / Critically ill: measured EE target with phase-of-illness considerations]
• Goal: [Maintenance / Gradual loss / Aggressive loss / Gain / Performance fueling]
• Recommended calorie range: [Lower–Upper kcal/day]
• Reassessment: [Timeline, e.g., "Reassess in 2–4 weeks or with ≥2–3% weight change."]

(If activity level unknown, note that targets should be refined once activity is clarified.)

Plan and Follow-Up

(Include when ongoing care is expected.)

• Nutrition plan: [Calorie target, macronutrient distribution, timing, route of feeding if applicable]
• Monitoring: [Weight trend, symptoms, glucose, training changes, tolerance]
• Follow-up: [Timeframe]
• Criteria for repeat testing: [Clinical change, weight change ≥2–3%, ventilator status change, new fever/infection, training load change]
• Communication: [Results sent to referring clinician / Team coordination]
• Counseling provided: [Topics covered; patient understanding; materials provided] (If applicable.)