Measuring Energy Expenditure in extracorporeal lung support Patients (MEEP) – Protocol, feasibility and pilot trial
| Autor: | N. Carbon, S. Frank, Claudia Spies, Philipp A. Pickerodt, Tobias Wollersheim, V. Skrypnikov, Knut Mai, Michael Müller, Steffen Weber-Carstens, Joachim Spranger |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine endocrine system ARDS medicine.medical_specialty medicine.medical_treatment Pilot Projects Critical Care and Intensive Care Medicine Extracorporeal 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine Interquartile range Internal medicine medicine Extracorporeal membrane oxygenation Humans 030109 nutrition & dietetics Nutrition and Dietetics Lung business.industry Calorimetry Indirect 030208 emergency & critical care medicine Gold standard (test) Oxygenation Middle Aged medicine.disease Surgery medicine.anatomical_structure Energy expenditure Cardiology Feasibility Studies Female Energy Metabolism business |
| Zdroj: | Clinical Nutrition. 37:301-307 |
| ISSN: | 0261-5614 |
| DOI: | 10.1016/j.clnu.2017.01.001 |
| Popis: | Summary Purpose Indirect calorimetry (IC) is the gold standard for measuring energy expenditure (EE). Due to O 2 uptake and CO 2 removal by both the extracorporeal lung support (ECLS) membrane and the lungs, a conventional IC is not feasible and no data available. Our MEEP (Measuring Energy Expenditure in ECLS Patients) protocol enables the determination of the REE in patients with ECLS, the comparison to patients without ECLS, and accuracy assessment of estimating equations. Methods In the MEEP protocol, a conventional IC is performed and extended by a calculation of the O 2 uptake and the CO 2 elimination by the ECLS membrane. Sum O 2 uptake and CO 2 elimination were used in the equation of Weir to calculate EE. We included 20 patients with ARDS on veno-venous (vv)-extracorporeal membrane oxygenation (ECMO) treatment, and 20 matched ARDS patients without ECLS as control. EE measurements were compared to the most prevalent predicting equations for EE. Results The new MEEP-protocol was shown to be feasible. None of the estimating equations matched the measured EE. Measured EE values did not significantly differ between the ARDS patients with vv-ECMO (2013 kcal/d [1786/2333]) and ARDS patients without ECLS (1857 kcal/d [1602/2085]) (p = 0.165). The blood flow through the vv-ECMO itself did not influence the EE. Conclusion Using the MEEP protocol, EE becomes easily measurable in patients with ECLS. We recommend the implementation of sequential measurements of EE in the critically ill, especially for patients with ECLS, but also for those without, in order to improve goal directed nourishment. |
| Databáze: | OpenAIRE |
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