Determining the appropriate resting energy expenditure requirement for severe trauma patients using indirect calorimetry in Korea: a restrospective observational study

Hak-Jae Lee, Sung-Bak Ahn, Jung Hyun Lee, Ji-Yeon Kim, Sungyeon Yoo, Suk-Kyung Hong
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Abstract

Purpose This study aimed to compare the resting energy expenditure (REE) measured using indirect calorimetry with that estimated using predictive equations in severe trauma patients to determine the appropriate caloric requirements. Methods Patients admitted to the surgical intensive care unit between January 2020 and March 2023 were included in this study. Indirect calorimetry was used to measure the patients’ REE values. These values were subsequently compared with those estimated using predictive equations: the weight-based equation (rule of thumb, 25 kcal/kg/day), Harris-Benedict, Ireton-Jones, and the Penn State 2003 equations. Results A total of 27 severe trauma patients were included in this study, and 47 indirect calorimetric measurements were conducted. The weight-based equation (mean difference [MD], –28.96±303.58 kcal) and the Penn State 2003 equation (MD, –3.56±270.39 kcal) showed the closest results to REE measured by indirect calorimetry. However, the REE values estimated using the Harris-Benedict equation (MD, 156.64±276.54 kcal) and Ireton-Jones equation (MD, 250.87±332.54 kcal) displayed significant differences from those measured using indirect calorimetry. The concordance rate, which the predictive REE differs from the measured REE value within 10%, was up to 36.2%. Conclusions The REE values estimated using predictive equations exhibited substantial differences from those measured via indirect calorimetry. Therefore, it is necessary to measure the REE value through indirect calorimetry in severe trauma patients. Keywords: Wounds and injuries; Indirect calorimetry; Nutritional requirements; Energy metabolism
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韩国使用间接量热法确定严重创伤患者适当的静息能量消耗需求:一项回顾性观察研究
本研究旨在比较严重创伤患者使用间接量热法测量的静息能量消耗(REE)与使用预测方程估计的REE,以确定适当的热量需求。方法选取2020年1月至2023年3月住院的外科重症监护病房患者。采用间接量热法测定患者的 REE值。随后将这些值与使用预测方程的估计值进行比较:基于体重的方程(经验法则,25千卡/公斤/天),哈里斯-本尼迪克特,艾顿-琼斯和宾夕法尼亚州立大学2003年的方程。结果本研究共纳入27例重型外伤患者,进行了47次间接量热测量。基于体重的方程(mean difference [MD], ´28.96±303.58 kcal)和Penn State 2003方程(MD, ´3.56±270.39 kcal)与间接量热法测量的REE结果最接近。然而,使用Harris-Benedict方程(MD, 156.64±276.54 kcal)和ieton - jones方程(MD, 250.87±332.54 kcal)估算的REE值与使用间接量热法测量的结果存在显著差异。预测REE值与实测值偏差在10%以内的一致性达36.2%。结论预测方程估算的稀土元素值与间接量热法测量的稀土元素值存在显著差异。因此,有必要通过间接量热法测量严重创伤患者的REE值。关键词:伤口损伤;间接量热法;营养需求;能量代谢
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审稿时长
11 weeks
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