Overview
This protocol outlines the standardized procedures for conducting metabolic testing in endocrine patients, ensuring accurate diagnosis and monitoring of metabolic disorders.
Pre-Test Requirements
Patient Preparation
- Fasting for 8-12 hours prior to testing
- No caffeine consumption for 24 hours
- Regular medications as per physician instructions
- Comfortable clothing recommended
Equipment Needed
- Indirect calorimeter
- Blood collection supplies
- Temperature-controlled environment (21-23°C)
- Calibrated scale and stadiometer
Testing Procedure
1. Baseline Measurements
- Record patient's height and weight
- Calculate BMI
- Measure vital signs
- Document current medications
2. Resting Metabolic Rate (RMR)
- Allow 10-minute rest period
- Perform RMR measurement for 15-20 minutes
- Record oxygen consumption and CO2 production
- Calculate respiratory quotient
3. Blood Analysis
- Collect fasting blood samples for:
- Comprehensive metabolic panel
- Thyroid function tests
- Lipid profile
- HbA1c
Quality Control
Calibration Requirements
- Daily gas analyzer calibration
- Weekly flow sensor verification
- Monthly system diagnostic check
Data Validation
- Verify steady-state conditions
- Check for measurement artifacts
- Ensure respiratory quotient within physiological range (0.7-1.0)
Result Interpretation
Normal Ranges
- RMR: ±10% of predicted values
- Respiratory Quotient: 0.7-1.0
- Energy Expenditure: Based on age/gender norms
Documentation
- Record all measurements in EMR
- Include any protocol deviations
- Note environmental conditions
Follow-up
- Schedule follow-up testing as indicated
- Provide results to referring physician
- Document recommendations for treatment modifications