标准化方程低估了烧伤和复杂伤口中的营养需求 患者 患者
Brooke Hartzell1, Nicholas Larson1
1Department of Surgery, Regions Hospital Burn Center, 640 Jackson Street, St. Paul, MN 55101, United States.
概括
标准化方程式低估了近30%的燃烧患者的热量需求. 间接热量计 (IC) 在这些复杂的情况下,可以更准确地评估代谢需求.
科学领域:
- 代谢反应的反应
- 烧伤患者的护理
- 营养支持 营养支持
背景情况:
- 用于估计烧伤患者的热量需求的标准化方程往往无法解释个体生理差异和受伤严重程度.
- 烧伤和大伤引起显著的超代谢状态,使热量需求超过传统预测.
- 传统方程无法适应这些代谢变化,因此需要更精确的方法来确定营养需求.
研究的目的:
- 为了测试标准化方程低估热量需求的假设,与烧伤患者的间接热量计 (IC) 测量相比.
- 为了比较预测的热量需求从既定方程与通过IC获得的测量需求.
- 评估预测方程与IC的准确性,以反映烧伤和伤病患者的超代谢反应.
主要方法:
- 一个回顾性观察性研究,分析来自烧伤中心的间接热量计 (IC) 测量.
- 将IC测量的热量需求与标准化方程的预测进行比较 (Harris Benedict,Schofield,Mifflin-St Jeor).
- 统计分析包括类内相关系数 (ICC) 和Bland-Altman图片来评估一致性;研究是无动力和探索性的.
主要成果:
- 标准化方程式低估了平均29.37%的热量需求.
- 在预测方程和IC测量之间观察到适度的一致性,ICC为0.70 (95%CI:0.49-0.84).
- 在20名不同患者身上进行了35次IC测量,平均年龄为45岁.
结论:
- 间接热量计 (IC) 似乎比传统的标准化方程更准确地表示烧伤和伤病患者的超代谢反应.
- 调查结果表明,当仅依赖烧伤患者的传统预测公式时,热量需求的报道显著不足.
- 需要进一步的强化研究来证实这些探索性发现,并改进使用IC的营养支持策略.
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