在急性阶段严重烧伤患者中通过间接热量计确定能源消耗的变化
Tuba Kuvvet Yoldaş1, Alev Atalay2, Kubilay Demirağ2
1Clinic of Anesthesiology and Reanimation, University of Health Sciences, Tepecik Education and Research Hospital, İzmir, TUR.
Cureus
|October 11, 2023
概括
严重的烧伤会引发高代谢状态,增加能量需求,特别是在第一周. 间接热量计监测对于管理这些关键患者至关重要.
科学领域:
- 临界护理医学 临界护理医学
- 代谢反应的反应
- 烧伤伤害管理管理
背景情况:
- 严重的烧伤伤害是全球健康面临的重大挑战.
- 持续的高代谢反应是严重烧伤的特征,需要仔细监测能源需求.
- 了解能源消耗对于最佳的患者护理和康复至关重要.
研究的目的:
- 为了研究严重烧伤的急性阶段的能源消耗变化.
- 使用间接热量计 (IC) 来评估烧伤患者的代谢变化.
- 为改善严重烧伤病例的营养支持策略提供数据.
主要方法:
- 研究了15名严重烧伤患者的队列,并应用了特定的排除标准.
- 间接热量计每周进行四周,以测量休息能量消耗 (REE) 和相关的代谢参数.
- 记录了人口统计数据,烧伤特征和临床分数 (APACHE II,SOFA,mNUTRIC).
主要成果:
- 在入院后的第一周观察到最高的代谢率 (REE,VO2,VCO2) 和发烧.
- 在接下来的几周,能量消耗和生理参数普遍下降.
- 患者结局包括20%的死亡率和80%的出院率.
结论:
- 严重烧伤患者在急性阶段表现出高代谢状态,最初一周的能量需求达到峰值.
- 建议定期间接测热量监测,以准确评估和满足烧伤患者的高能量需求.
- 这种方法支持在长时间的高代谢过程中量身定制的营养管理.
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