Upstate Medical University, Syracuse, New York, USA.
Curr Opin Crit Care. 2012 Apr;18(2):174-7. doi: 10.1097/MCC.0b013e3283514bbc.
The review focuses on current methodology for the most accurate way to determine resting metabolic rate in critically ill patients and to evaluate whether application of any particular method improves clinical outcome.
Consensus is that indirect calorimetry is the most accurate method for determining resting metabolic rate. Whenever an alternate method of determining energy expenditure is tested (e.g. equations), the criterion method used in the validation is indirect calorimetry. Of the alternates to indirect calorimetry, the Penn State equation has the strongest validation work supporting it. No study has been undertaken to determine whether the drop in accuracy associated with estimation methods translates into deterioration in clinical outcome compared to nutrition support guided by measurements.
Indirect calorimetry is the most accurate way to determine calorie needs in critically ill patients. Compared to indirect calorimetry, metabolic rate equations are accurate about 75% of the time. No study has been performed to determine whether the measurement or estimation method improves clinical outcome.
本文重点介绍目前最精确测量危重症患者静息代谢率的方法，并评估应用任何特定方法是否能改善临床结局。
间接量热法是确定静息代谢率最准确的方法，这已达成共识。每当测试一种替代的能量消耗测定方法（如方程）时，验证中使用的标准方法都是间接量热法。在间接量热法的替代方法中，宾夕法尼亚州立大学方程具有最强的验证工作支持。目前还没有研究来确定与基于测量的营养支持相比，与估计方法相关的准确性下降是否会导致临床结局恶化。
间接量热法是测量危重症患者热量需求最准确的方法。与间接量热法相比，代谢率方程的准确性约为 75%。目前还没有研究来确定测量或估计方法是否能改善临床结局。
