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在严重烧伤中使用可生物降解皮肤基质后的能源消耗:试点研究
Sara Dowling1, Rochelle Kurmis2, Jessica Gauro1
1Adult Burns Service, Royal Adelaide Hospital, Central Adelaide Local Health Network, Port Road, Adelaide, 5000, Australia; Department of Nutrition and Dietetics, Royal Adelaide Hospital, Central Adelaide Local Health Network, Port Road, Adelaide, 5000, Australia.
Clinical nutrition ESPEN
|May 1, 2025
概括
在严重烧伤中使用可生物降解的缓解矩阵 (BTM) 并没有引起显著的超能代谢. 间接热量计对于准确的营养支持至关重要,因为预测方程显示了变化.
科学领域:
- 对严重烧伤和皮肤替代品的代谢反应.
- 在重症监护中的营养支持策略.
- 在重建性外科手术中的生物材料.
背景情况:
- 可生物降解的缓解矩阵 (BTM) 是全厚烧伤的皮肤替代品.
- 应用BTM的代谢影响仍然在很大程度上是未知的.
- 这项研究调查了严重烧伤患者的能量消耗和预测方程的准确性.
研究的目的:
- 测量BTM应用后使用间接热量计 (IC) 测量能源支出变化.
- 评估成年严重烧伤患者常见预测能量方程的准确性.
- 评估BTM在燃烧管理不同阶段的代谢效应.
主要方法:
- 间接热量计 (IC) 测量了"急性手术"",BTM整合"",皮肤移植"和"急性恢复"期间的能量消耗 (MEE).
- MEE与预测方程进行了比较:多伦多,斯科菲尔德+伤害因子 (IF) 和比率方法 (25-40 kcal/kg/day).
- 使用林的一致性相关系数 (CCC) 和布兰德-阿尔特曼分析来评估协议.
主要成果:
- 在所有测量期间 (25-41%,p < 0.001) 中,MEE明显高于预测的基础代谢率.
- 大多数预测方程都高估了能源需求,除了多伦多方程,该方程显示出最佳一致性 (CCC=0.77),但仍然表现出变化.
- 没有任何实质性的超代谢反应直接归因于BTM应用本身.
结论:
- 在重度烧伤患者中,BTM的应用没有诱导显著的超代谢反应.
- 多伦多方程在测试过的能耗预测方程中显示出最高的准确性.
- 为了准确的营养指导,建议使用间接热量计,因为预测方法的变化和患者需求的变化.
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