Dickerson R N, Vehe K L, Mullen J L, Feurer I D
Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy and Science, PA 19104-4495.
Crit Care Med. 1991 Apr;19(4):484-90. doi: 10.1097/00003246-199104000-00005.
To assess the resting energy expenditure of hospitalized patients with pancreatitis.
Prospective, case-referent study.
Nutrition support service in a university tertiary care hospital.
Patients referred to the Nutrition Support Service with the diagnosis of pancreatitis. Excluded from study entry included those with cancer, obesity (greater than 150% ideal body weight), those measured within 3 postoperative days, or patients requiring ventilator support with an FIO2 of greater than 0.5. Forty-eight patients with either acute pancreatitis (n = 13), chronic pancreatitis (n = 24), acute pancreatitis with sepsis (n = 7), or chronic pancreatitis with sepsis (n = 7) were studied. The two septic groups were combined into a single pancreatitis-with-sepsis group, since no significant differences among measured variables were observed between individual septic groups.
None.
Resting energy expenditure was measured by indirect calorimetry and compared with the predicted energy expenditure, as determined by the Harris-Benedict equations. Resting energy expenditure (percent of predicted energy expenditure) was significantly (p less than .02) greater for patients with pancreatitis complicated by sepsis (120 +/- 11%) compared with the nonseptic chronic pancreatitis group (105 +/- 14%). Resting energy expenditure for the nonseptic acute pancreatitis patients (112 +/- 17%) was not significantly different from the other groups. The septic pancreatitis group had the largest percentage (82%) of hypermetabolic (resting energy expenditure greater than 110% of predicted energy expenditure) patients, whereas 61% and 33% of the acute and chronic pancreatitis groups were hypermetabolic, respectively (p less than .02).
Resting energy expenditure is variable in patients with pancreatitis (77% to 139% of predicted energy expenditure). The Harris-Benedict equations are an unreliable estimate of caloric expenditure. Septic complications are associated with hypermetabolism and may be the most important factor influencing resting energy expenditure in pancreatitis patients.
评估胰腺炎住院患者的静息能量消耗。
前瞻性病例对照研究。
一所大学三级护理医院的营养支持服务部门。
被转至营养支持服务部门且诊断为胰腺炎的患者。排除标准包括患有癌症、肥胖（超过理想体重的150%）、术后3天内进行测量的患者，或需要使用FIO2大于0.5的呼吸机支持的患者。对48例患有急性胰腺炎（n = 13）、慢性胰腺炎（n = 24）、伴有脓毒症的急性胰腺炎（n = 7）或伴有脓毒症的慢性胰腺炎（n = 7）的患者进行了研究。由于在各个脓毒症组之间未观察到测量变量的显著差异，因此将两个脓毒症组合并为一个伴有脓毒症的胰腺炎组。
无。
通过间接测热法测量静息能量消耗，并与根据哈里斯-本尼迪克特方程确定的预测能量消耗进行比较。与非脓毒症慢性胰腺炎组（105±14%）相比，伴有脓毒症的胰腺炎患者的静息能量消耗（预测能量消耗的百分比）显著更高（p<0.02）（120±11%）。非脓毒症急性胰腺炎患者的静息能量消耗（112±17%）与其他组无显著差异。脓毒症胰腺炎组的高代谢患者百分比最高（82%），而急性和慢性胰腺炎组的高代谢患者分别为61%和33%（p<0.02）。
胰腺炎患者的静息能量消耗存在差异（为预测能量消耗的77%至139%）。哈里斯-本尼迪克特方程对热量消耗的估计不可靠。脓毒症并发症与高代谢有关，可能是影响胰腺炎患者静息能量消耗的最重要因素。
