在住院患者中,测量与估计的能量需求相比
Caroline P Houmøller1, Sebastian H Hellerup1, Niels K Nøhr1
1Department of Health, Science and Technology, Aalborg University, Denmark.
Clinical nutrition ESPEN
|January 14, 2024
概括
估计的能源消耗往往低估了患者的实际需求,与CRP,年龄和呼吸速率等因素相关的显著差异. 准确的能源评估对于住院患者至关重要.
科学领域:
- 临床营养学 临床营养学
- 代谢研究研究 代谢研究
- 患者监测 患者监测
背景情况:
- 准确确定患者的能量需求至关重要,但像哈里斯·本尼迪克特方程 (HB) 这样的预测公式与间接热量计 (IC) 相比显示出变化.
- 在非重症住院患者的测量和估计能源需求之间的比较中存在报告不足.
- 以前的研究表明,HB高估或低估了特定人群的能源需求.
研究的目的:
- 评估在个体住院患者中测量能量需求与哈里斯·本尼迪克特 (HB) 方程估计的能量需求之间的一致性.
- 为了确定与测量和估计的能量需求之间的差异相关的患者特征.
- 为了比较HB估计与间接热量计 (IC) 和营养师估计在一般医院病房设置.
主要方法:
- 间接热量计 (IC) 用于测量86名患者的休息能量消耗 (REE).
- 对67名患者的身体组成进行了生物阻抗分析 (BIA).
- 收集了身高,体重,BMI,小腿周长,病房,生命体征,营养师估计和血液样本的数据;统计分析包括布兰德-阿尔特曼图表,回归和奇平方测试.
主要成果:
- 在IC和HB (6.2%),饮食师估计 (7.8%) 和BIA (4.50%) 之间观察到统计学上显著的平均差异.
- 休息能量消耗 (REE) 与骨肌肉质量 (SMM),身体脂肪质量 (BFM) 和体重有显著的关联.
- 诸如C-反应蛋白 (CRP),年龄,手术状态和呼吸速率等因素与测量的REE和HB估计值有关.
结论:
- 这项研究显示,与测量的REE相比,预测公式普遍低估了能源支出.
- 测量的REE和身体组成指标 (SMM,BFM) 和体重之间存在显著的相关性.
- 测量和估计的能量需求之间的差异大于±10%与较高的CRP水平,年龄较大,手术患者的状态和呼吸率升高有关.
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