预测方程和在重症监护中的间接热量计的比较:根据体重指数的分类,准确性是否有所不同?
Gretchen Murray1,2, Sheela Thomas2, Timothy Dunlea3
1School of Health and Rehabilitation Science, The Ohio State University, Columbus, Ohio, USA.
概括
危急病患者的预测方程往往低估了能量需求,导致营养不良. 间接热量计是首选的,但基于体重的诺米克可能是一个可行的替代品,当它是不可用的.
科学领域:
- 关键护理医学 关键护理医学
- 营养科学 营养科学
- 代谢研究的研究.
背景情况:
- 对重症患者来说,估计能源需求至关重要.
- 当前的预测方程往往导致营养支持低于最佳,并导致不良结果.
- 间接热量计 (IC) 是黄金标准,但其可访问性有限.
研究的目的:
- 为了比较常见的预测方程与危急病患者间接热量计的准确性.
- 评估身体质量指数 (BMI) 对能源支出估计准确性的影响.
- 确定潜在的替代方法来估计能源需求,当IC是不可行的.
主要方法:
- 追溯对326名接受IC治疗的危急病患者的图表审查.
- 使用招生权重计算了Mifflin-St Jeor (MSJ) 和宾夕法尼亚州立大学 (PSU) 的方程和基于重量的名ograms.
- 按BMI分类分层数据,并比较估计与测量的能源消耗.
主要成果:
- 在所有BMI类别中,MSJ和PSU方程都与IC正相关.
- 测量的能源支出显著高于PSU,MSJ和基于重量的名录的估计 (1.1-1.3倍).
- 基于体重的诺姆图表为正常体重和超重患者提供了最接近IC的估计.
结论:
- 预测方程显著低估了重症患者的能量需求,可能导致营养不良和不良结果.
- 应优先考虑间接热量计;建议增加对其解释的培训.
- 在没有IC的情况下,基于入院体重的名录可以作为更接近的替代品,特别是对于非肥胖患者.
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