Indirect calorimetry in postoperative patients with acute renal failure

Oxygen consumption was measured and caloric expenditure calculated (indirect calorimetry) in ten adult patients with acute renal failure (ARF) following surgery. Eight patients recovered from ARF and six were discharged from the hospital. Caloric expenditure averaged 47 Kcal/kg/24 hours during the period of AFR. Attempts were made to match caloric replacement with expenditure based on indirect calorimetry, but was achieved in only one patient. Indirect calorimetry appears to be a practical method for guiding caloric replacement in these patients. Postoperative patients in ARF must undergo healing of incisions and bowel anastomoses, and contain infection. Since these patients are severely catabolic, it seems reasonable to treat them with adequate protein and calories and to use dialysis to control azotemia and water metabolism.