Tancheva D, Arabadziev J, Gergov G, Lachev N, Todorova S, Hristova A
Pirogov Emergency Medicine Hospital, Centre for Burns and Plastic Surgery, Sofia, Bulgaria.
Ann Burns Fire Disasters. 2005 Mar 31;18(1):16-8.
Severe burn injuries give rise to an extreme state of physiological stress. No other trauma results in such an accelerated rate of tissue catabolism, loss of lean body mass, and depletion of energy and protein reserves. A heightened attention to energy needs is essential, and the significance of adequate nutritional support in the complex management of patients with major burns is very important. The purpose of this study is to compare the results obtained by three of the most popular methods of estimating energy requirements in severely burned adult patients with the measurements of resting energy (REE) expenditure by indirect calorimetry (IC). A prospective study was carried out of 20 patients (male/female ratio, 17/3; mean age, 37.83 ± 10.86 yr), without accompanying morbidities, with burn injuries covering a mean body surface area of 34.27 ± 11.55% and a mean abbreviated burn severity index of 7.44 ± 1.58. During the first 30 days after trauma, the energy requirements were estimated using the Curreri, Long, and Toronto formulas. Twice weekly measurements of REE by IC were obtained. It was found that the Curreri and Long formulas overestimated the energy requirements in severely burned patients, as found by other investigators. However, no significant difference was found between the daily energy requirements calculated by the Toronto formula and the measured REE values by IC. It is concluded that the Toronto formula can be used as an alternative method for estimating the energy requirements of patients with major burns in cases where IC is not available or not applicable.
严重烧伤会引发极端的生理应激状态。没有其他创伤会导致如此快速的组织分解代谢、瘦体重丧失以及能量和蛋白质储备的消耗。高度关注能量需求至关重要，充足的营养支持在重度烧伤患者的综合治疗中具有极其重要的意义。本研究的目的是比较三种最常用的估计成年重度烧伤患者能量需求的方法与通过间接测热法（IC）测量的静息能量（REE）消耗结果。对20例患者（男/女比例为17/3；平均年龄37.83±10.86岁）进行了一项前瞻性研究，这些患者无伴随疾病，烧伤平均体表面积为34.27±11.55%，平均简略烧伤严重程度指数为7.44±1.58。在创伤后的前30天，使用Curreri、Long和多伦多公式估计能量需求。每周通过IC测量两次REE。结果发现，如其他研究者所发现的，Curreri和Long公式高估了重度烧伤患者的能量需求。然而，多伦多公式计算的每日能量需求与IC测量的REE值之间未发现显著差异。结论是，在无法使用或不适用IC的情况下，多伦多公式可作为估计重度烧伤患者能量需求的替代方法。
