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Research regarding the impact of acute spinal cord injury (aSCI) on energy expenditure is limited. Patients with aSCI are prone to complications of both over- and under-feeding, making appropriate nutrition support pivotal to patient care. The purpose of this study was to describe energy expenditure and assess the performance of predictive equations in mechanically ventilated adults with aSCI. Adult patients admitted to a single trauma center from March 2017 through June 2018 with aSCI and a documented indirect calorimetry (IC) within 6 weeks of injury were