{"title":"呼吸间接量热法和HB系数法指导败血症患者靶能量的比较研究","authors":"Xiaojuan Yang, Jun Zhang, Lijuan Wang","doi":"10.3760/CMA.J.ISSN.1674-635X.2019.04.007","DOIUrl":null,"url":null,"abstract":"Objective \nTo explore the effects of nutritional supports following target energy measured by respiratory indirect calorimetry and HB coefficient method respectively on the nutrition and immune indexes of patients with sepsis. \n \n \nMethods \nA prospective comparative study of 60 patients with sepsis who was suitable for nutritional support and respiratory indirect calorimetry in the intensive care unit (ICU) of the hospital from January 2015 to October 2015 was conducted. Resting Energy Expenditure (REE) was measured simultaneously by respiratory indirect calorimetry (n=30) and HB coefficient (Harris-Benedict formula×stress coefficient, n=30) in patients with sepsis and the nutritional support was given according to the MREE measured by the two methods. The nutritional and immune indexes were obtained at 0 day, 3 day, 7 day, and 14 day after nutritional support. The nutritional and immune indexes at 0 day were considered as the baseline and the differences in the nutritional and immune indexes between the baseline and 3 day, 7 day and 14 day were expressed as a \"Δ\". Values of Δ were compared between the two goups. \n \n \nResults \nWith nutritional support for 3 days, Δalbumin, Δ prealbumin, Δthe total T lymphocytes, Δassist/induction of T cells and ΔIgG were higher in the respiratory indirect calorimetry group than in the HB coefficient group (P<0.05). With nutritional support for 7 days, Δalbumin, ΔT lymphocytes, ΔIgM were higher in the respiratory indirect calorimetry group than in the HB coefficient group (P<0.05). With nutritional support for 14 days, Δtransferrin, Δsuppression/cytotoxic T cells, ΔIgG, ΔIgA, ΔC3 andΔC4 were higher in the respiratory indirect calorimetry group than in the HB coefficient group(P<0.05). \n \n \nConclusion \nNutritional support with REE measured by respiratory indirect calorimetry in patients with sepsis is more effective on nutritional and immune related indexes improvement have different degrees of improvement, thus respiratory indirect calorimetry is more suitable to guide the target energy of sepsis patients. \n \n \nKey words: \nSepsis; Target energy; Respiratory indirect calorimetry; HB coefficient; Nutrition","PeriodicalId":9877,"journal":{"name":"中华临床营养杂志","volume":"27 1","pages":"238-243"},"PeriodicalIF":0.0000,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A comparative study of the respiratory indirect calorimetry and HB coefficient method for the guidance of the target energy in patients with sepsis\",\"authors\":\"Xiaojuan Yang, Jun Zhang, Lijuan Wang\",\"doi\":\"10.3760/CMA.J.ISSN.1674-635X.2019.04.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective \\nTo explore the effects of nutritional supports following target energy measured by respiratory indirect calorimetry and HB coefficient method respectively on the nutrition and immune indexes of patients with sepsis. \\n \\n \\nMethods \\nA prospective comparative study of 60 patients with sepsis who was suitable for nutritional support and respiratory indirect calorimetry in the intensive care unit (ICU) of the hospital from January 2015 to October 2015 was conducted. Resting Energy Expenditure (REE) was measured simultaneously by respiratory indirect calorimetry (n=30) and HB coefficient (Harris-Benedict formula×stress coefficient, n=30) in patients with sepsis and the nutritional support was given according to the MREE measured by the two methods. The nutritional and immune indexes were obtained at 0 day, 3 day, 7 day, and 14 day after nutritional support. The nutritional and immune indexes at 0 day were considered as the baseline and the differences in the nutritional and immune indexes between the baseline and 3 day, 7 day and 14 day were expressed as a \\\"Δ\\\". Values of Δ were compared between the two goups. \\n \\n \\nResults \\nWith nutritional support for 3 days, Δalbumin, Δ prealbumin, Δthe total T lymphocytes, Δassist/induction of T cells and ΔIgG were higher in the respiratory indirect calorimetry group than in the HB coefficient group (P<0.05). With nutritional support for 7 days, Δalbumin, ΔT lymphocytes, ΔIgM were higher in the respiratory indirect calorimetry group than in the HB coefficient group (P<0.05). With nutritional support for 14 days, Δtransferrin, Δsuppression/cytotoxic T cells, ΔIgG, ΔIgA, ΔC3 andΔC4 were higher in the respiratory indirect calorimetry group than in the HB coefficient group(P<0.05). \\n \\n \\nConclusion \\nNutritional support with REE measured by respiratory indirect calorimetry in patients with sepsis is more effective on nutritional and immune related indexes improvement have different degrees of improvement, thus respiratory indirect calorimetry is more suitable to guide the target energy of sepsis patients. \\n \\n \\nKey words: \\nSepsis; Target energy; Respiratory indirect calorimetry; HB coefficient; Nutrition\",\"PeriodicalId\":9877,\"journal\":{\"name\":\"中华临床营养杂志\",\"volume\":\"27 1\",\"pages\":\"238-243\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-08-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华临床营养杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2019.04.007\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Nursing\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华临床营养杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1674-635X.2019.04.007","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Nursing","Score":null,"Total":0}
A comparative study of the respiratory indirect calorimetry and HB coefficient method for the guidance of the target energy in patients with sepsis
Objective
To explore the effects of nutritional supports following target energy measured by respiratory indirect calorimetry and HB coefficient method respectively on the nutrition and immune indexes of patients with sepsis.
Methods
A prospective comparative study of 60 patients with sepsis who was suitable for nutritional support and respiratory indirect calorimetry in the intensive care unit (ICU) of the hospital from January 2015 to October 2015 was conducted. Resting Energy Expenditure (REE) was measured simultaneously by respiratory indirect calorimetry (n=30) and HB coefficient (Harris-Benedict formula×stress coefficient, n=30) in patients with sepsis and the nutritional support was given according to the MREE measured by the two methods. The nutritional and immune indexes were obtained at 0 day, 3 day, 7 day, and 14 day after nutritional support. The nutritional and immune indexes at 0 day were considered as the baseline and the differences in the nutritional and immune indexes between the baseline and 3 day, 7 day and 14 day were expressed as a "Δ". Values of Δ were compared between the two goups.
Results
With nutritional support for 3 days, Δalbumin, Δ prealbumin, Δthe total T lymphocytes, Δassist/induction of T cells and ΔIgG were higher in the respiratory indirect calorimetry group than in the HB coefficient group (P<0.05). With nutritional support for 7 days, Δalbumin, ΔT lymphocytes, ΔIgM were higher in the respiratory indirect calorimetry group than in the HB coefficient group (P<0.05). With nutritional support for 14 days, Δtransferrin, Δsuppression/cytotoxic T cells, ΔIgG, ΔIgA, ΔC3 andΔC4 were higher in the respiratory indirect calorimetry group than in the HB coefficient group(P<0.05).
Conclusion
Nutritional support with REE measured by respiratory indirect calorimetry in patients with sepsis is more effective on nutritional and immune related indexes improvement have different degrees of improvement, thus respiratory indirect calorimetry is more suitable to guide the target energy of sepsis patients.
Key words:
Sepsis; Target energy; Respiratory indirect calorimetry; HB coefficient; Nutrition
期刊介绍：
The Chinese Journal of Clinical Nutrition was founded in 1993. It is the first professional academic journal (bimonthly) in my country co-sponsored by the Chinese Medical Association and the Chinese Academy of Medical Sciences to disseminate information on clinical nutrition support, nutrient metabolism, the impact of nutrition support on outcomes and "cost-effectiveness", as well as translational medicine and nutrition research. It is also a professional journal of the Chinese Medical Association's Parenteral and Enteral Nutrition Branch.
The purpose of the Chinese Journal of Clinical Nutrition is to promote the rapid dissemination of knowledge on nutrient metabolism and the rational application of parenteral and enteral nutrition, focusing on the combination of multidisciplinary and multi-regional field investigations and clinical research. It mainly reports on nutritional risk screening related to the indications of parenteral and enteral nutrition support, "cost-effectiveness" research on nutritional drugs, consensus on clinical nutrition, guidelines, expert reviews, randomized controlled studies, cohort studies, glycoprotein and other nutrient metabolism research, systematic evaluation of clinical research, evidence-based case reports, special reviews, case reports and clinical experience exchanges, etc., and has a special column on new technologies related to the field of clinical nutrition and their clinical applications.
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