Correlation Between Measured Energy Expenditure and Clinically Obtained Variables in Trauma and Sepsis Patients
| Autor: | John H. Siegel, Shirin Goodarzi, David C. Frankenfield, Suzanne Bagley, Laurel A. Oniert, Charles E. Wiles, Michael M. Badellino |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Adult
Male medicine.medical_specialty 030309 nutrition & dietetics Dopamine medicine.medical_treatment Medicine (miscellaneous) Severity of Illness Index Fentanyl Sepsis 03 medical and health sciences 0302 clinical medicine Trauma Centers Dobutamine Severity of illness medicine Humans Resting energy expenditure Mechanical ventilation 0303 health sciences Nutrition and Dietetics Morphine Multiple Trauma business.industry Calorimetry Indirect medicine.disease Surgery Anesthesia Basal metabolic rate Female 030211 gastroenterology & hepatology Analgesia Neuromuscular Blocking Agents Energy Metabolism business Respiratory minute volume medicine.drug |
| Zdroj: | Journal of Parenteral and Enteral Nutrition. 18:398-403 |
| ISSN: | 1941-2444 0148-6071 |
| DOI: | 10.1177/0148607194018005398 |
| Popis: | BACKGROUND Indirect calorimetry is the preferred method for determining caloric requirements of patients, but availability of the device is limited by high cost. A study was therefore conducted to determine whether clinically obtainable variables could be used to predict metabolic rate. METHODS Patients with severe trauma or sepsis who required mechanical ventilation were measured by an open-circuit indirect calorimeter. Several clinical variables were obtained simultaneously. Measurements were repeated every 12 hours for up to 10 days. RESULTS Twenty-six trauma and 30 sepsis patients were measured 423 times. Mean resting energy expenditure was 36 +/- 7 kcal/kg (trauma) vs 45 +/- 8 kcal/kg (sepsis) (p < .0001). The single strongest correlate with resting energy expenditure was minute ventilation (R2 = 0.61, p < .0001). Doses of dopamine, dobutamine, morphine, fentanyl, and neuromuscular blocking agents each correlated positively with resting energy expenditure. In the case of the inotropics and neuromuscular blockers, there was a probable covariance with severity of illness. A multiple regression equation was developed using minute ventilation, predicted basal energy expenditure, and the presence or absence of sepsis: resting energy expenditure = -11000 + minute ventilation (100) + basal energy expenditure (1.5) + dobutamine dose (40) + body temperature (250) + diagnosis of sepsis (300) (R2 = 0.77, p < .0001). CONCLUSION Severe trauma and sepsis patients are hypermetabolic, but energy expenditure is predictable from clinical data. The regression equations probably apply only to severe trauma and sepsis. Other studies should be conducted to predict energy expenditure in other patient types. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text