https://www.selleckchem.com/products/beta-aminopropionitrile.html of critically ill adults remain largely supported by expert opinion and only a minority by high-quality evidence. An urgent unmet clinical need for high-quality clinical trials is warranted. Published guideline recommendations for the nutritional management of critically ill adults remain largely supported by expert opinion and only a minority by high-quality evidence. An urgent unmet clinical need for high-quality clinical trials is warranted. Both overfeeding and underfeeding of intensive care unit (ICU) patients are associated with worse outcomes. Predictive equations of nutritional requirements, though easily implemented, are highly inaccurate. Ideally, the individual caloric target is based on the frequent assessment of energy expenditure (EE). Indirect calorimetry is considered the gold standard but is not always available. EE estimated by ventilator-derived carbon dioxide consumption (EEVCO ) has been proposed as an alternative to indirect calorimetry, but there is limited evidence to support the use of this method. We prospectively studied a cohort of adult critically ill patients requiring mechanical ventilation and artificial nutrition. We aimed to compare the performance of the EEVCO with the EE measured by indirect calorimetry through the calculation of bias and precision (accuracy), agreement, reliability and 10% accuracy rates. The effect of including the food quotient (nutrition intake derived respiratory quotient) in contrast O2 method is used. Including the food quotient into the EEVCO2 equation does not improve its performance. Predictive equations, although inaccurate, may even predict energy expenditure better compared with the VCO2-method. Indirect calorimetry remains the gold standard method. This cohort study assessed the effect of disease-related malnutrition (DRM) and fluid overload (FO) evaluated by bioimpedance vector analysis (BIVA) on mortality among hospitalized patients.