Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8 FI-20520 Turku, Finland.
Nutr Metab (Lond). 2010 Aug 26;7:70. doi: 10.1186/1743-7075-7-70.
Amyotrophic lateral sclerosis (ALS) is a form of degenerative motor neuron disease. At the end stage of the disease artificial feeding is often required. Nevertheless, very little is known about the energy demand of those ALS patients who are chronically dependent on tracheostomy intermittent positive pressure ventilation. The objective of our study was to clarify the resting energy expenditure (REE) in mechanically ventilated ALS patients.
We measured the REE of five ALS patients (four men, one female) twice during a 12 month-period using indirect calorimetry with two sampling flow settings (40 L/min and 80 L/min). The measured REEs (mREE) were compared with values calculated using five different predictive equations.
The mean (± SD) of all mREEs was 1130 ± 170 kcal/d. The measurements with different flow settings and at different time instances provided similar results. The mean of mREEs was 33.6% lower, as compared to the mean calculated with five different predictive equations REE (p < 0.001). Each of the predictive equations over-estimated the REE.
The mREE values were significantly lower for every patient than all the predicted ones. Determination of daily nutrition with predictive equations may therefore lead in mis-estimation of energy requirements. Because ALS patients may live years with artificial ventilation their nutritional support should be based on individual measurements. However, further study is needed due to the small number of subjects.
肌萎缩侧索硬化症（ALS）是一种退行性运动神经元疾病。在疾病的晚期，通常需要人工喂养。然而，对于长期依赖气管造口间歇性正压通气的 ALS 患者，人们对其能量需求知之甚少。我们的研究目的是阐明机械通气的 ALS 患者的静息能量消耗（REE）。
我们使用间接热量法，在 12 个月的时间内，通过两种采样流量设置（40 L/min 和 80 L/min），两次测量了五名 ALS 患者（四名男性，一名女性）的 REE。测量的 REE（mREE）与使用五种不同预测方程计算的值进行了比较。
所有 mREE 的平均值（± SD）为 1130 ± 170 kcal/d。不同流量设置和不同时间点的测量结果相似。与使用五种不同预测方程计算的 REE 相比，mREE 的平均值低 33.6%（p < 0.001）。每个预测方程都高估了 REE。
每位患者的 mREE 值均明显低于所有预测值。因此，使用预测方程确定每日营养可能会导致对能量需求的错误估计。由于 ALS 患者可能需要多年的人工通气，因此他们的营养支持应基于个体测量。然而，由于研究对象数量较少，还需要进一步的研究。
