Which condition warrants applying a stress factor of 1.2-1.5 to REE when estimating energy needs?

Which condition warrants applying a stress factor of 1.2-1.5 to REE when estimating energy needs?

• A. Sepsis or trauma
• B. Diabetes
• C. Hypertension
• D. Obesity

Answer: (A)

When estimating energy needs, you adjust resting energy expenditure (REE) by a stress factor to reflect how illness or injury drives up metabolism. Sepsis or trauma triggers a strong inflammatory and catabolic response, increasing energy expenditure beyond baseline. Multiplying REE by about 1.2 to 1.5 captures that extra demand, giving a more accurate estimate of total energy needs during these acute stress states. Diabetes, hypertension, and obesity are not, in themselves, acute stress states that automatically require this level of adjustment. Diabetes and hypertension are chronic conditions managed differently, and obesity involves different considerations for energy estimation (often using adjusted body weight) rather than applying this stress factor to REE unless there is another acute illness or injury present.

When estimating energy needs, you adjust resting energy expenditure (REE) by a stress factor to reflect how illness or injury drives up metabolism. Sepsis or trauma triggers a strong inflammatory and catabolic response, increasing energy expenditure beyond baseline. Multiplying REE by about 1.2 to 1.5 captures that extra demand, giving a more accurate estimate of total energy needs during these acute stress states.

Diabetes, hypertension, and obesity are not, in themselves, acute stress states that automatically require this level of adjustment. Diabetes and hypertension are chronic conditions managed differently, and obesity involves different considerations for energy estimation (often using adjusted body weight) rather than applying this stress factor to REE unless there is another acute illness or injury present.