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使用预测方程对严重烧伤的成年人进行休息能量消耗的估计:系统审查和元分析

Yiran Wang^1,2, Jing Jiang^1,2, Meixuan Liu^1,2

¹Department of Burns & Wound Care Center, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China.

JPEN. Journal of parenteral and enteral nutrition

|February 27, 2024

概括

使用常见方程,估计严重烧伤患者的休息能量消耗 (REE) 是不准确的. 建议使用间接热量计 (IC) 进行精确的REE测量,多伦多,1.5HB或Ireton-Jones方程作为替代方法.

科学领域:

代谢医学是一种代谢医学.
临床营养学临床营养学
烧伤护理烧伤护理

背景情况:

估计休息能量消耗 (REE) 对烧伤患者的营养支持至关重要.
目前在烧伤患者中对REE的预测方程缺乏关于准确性的共识.
本综述评估了严重烧伤患者常用的REE方程的偏差和精度.

研究的目的:

系统地审查和比较用于预测严重烧伤的成年患者REE的各种方程的准确性.
为了确定最可靠的方程来估计REE当间接热量计是不可用的.
为烧伤幸存者提供最佳营养支持策略的信息.

主要方法:

在主要数据库 (PubMed,科学网,Embase,Cochrane图书馆) 进行了系统的文献搜索,截至2023年6月1日.
包括比较预测REE (方程) 与成年烧伤患者测量REE (间接热量计) 的研究.
进行了元分析,以评估每个预测方程的偏差和精度.

主要成果:

在9项研究中评估了12个方程.
多伦多方程表现出最低的偏差,其次是哈里斯-贝内迪克特×1.5 (1.5HB) 和米尔纳方程.
所有方程都显示精度低于50%;Ireton-Jones显示精度最高 (41.2%),其次是1.5HB (37.0%) 和多伦多 (34.7%).

结论:

通常使用的REE预测方程对于成年烧伤患者是不准确的.
间接热量计 (IC) 是准确测量REE的黄金标准.
当IC不可行时,多伦多,1.5HB或Ireton-Jones方程可以作为参考;需要进一步研究改进模型.

关键词:

能源支出能源支出营养支持营养支持预测方程休息时间严重的烧伤严重的烧伤

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