Adolph M, Eckart J
Institut für Anästhesiologie und operative Intensivmedizin Krankenhauszweckverband Augsburg.
Infusionstherapie. 1990 Feb;17(1):5-16.
There is always a distinct increase in energy expenditure in postoperative, posttraumatic and septic patients. In order to predict this increase in energy expenditure an enormous number of formulas have been developed. However, the problem with all these formulas is that they cannot sufficiently take into account the peculiarities of the underlying disease, the general and nutritional condition or the varying influence of the phase of disease. Furthermore, all these patients continuously show a considerable change in body weight which can be attributed to a shifting of the water balance. In all of these cases any calculation of energy expenditure based on body weight will inevitably be incorrect. Therefore, it is recommended that predicting formulas only be used as orienting guidelines in all uncomplicated postoperative or posttraumatic courses. In patients with multiple injuries or septic complications the real energy expenditure should be measured by indirect calorimetry in order to adapt energy intake during enteral or parenteral nutrition to the very different metabolic situations.
术后、创伤后及脓毒症患者的能量消耗总会显著增加。为了预测这种能量消耗的增加，人们开发了大量公式。然而，所有这些公式的问题在于，它们无法充分考虑基础疾病的特殊性、一般状况和营养状况，或疾病阶段的不同影响。此外，所有这些患者的体重持续出现相当大的变化，这可归因于水平衡的改变。在所有这些情况下，基于体重计算能量消耗必然会出现错误。因此，建议在所有无并发症的术后或创伤后病程中，预测公式仅用作指导方针。对于多发伤或脓毒症并发症患者，应通过间接测热法测量实际能量消耗，以便在肠内或肠外营养期间使能量摄入适应非常不同的代谢状况。
