Department of Paediatrics, Division Medicine, Imperial College, St Mary's Campus, London, UK.
Nutr Clin Pract. 2012 Oct;27(5):669-76. doi: 10.1177/0884533612448479. Epub 2012 Jun 7.
Traditionally, energy requirements have been calculated using predictive equations. These methods have failed to calculate energy expenditure accurately. Routine indirect calorimetry has been suggested, but this method is technically demanding and costly. This study aimed to develop a new predictive equation to estimate energy requirements for critically ill children.
This prospective, observational study on ventilated children included patients with an endotracheal tube leak of < 10% and fractional inspired oxygen of < 60%. An indirect calorimetry energy expenditure measurement was performed and polynomial regression analysis was used to develop new predictive equations. The new formulas were then compared with existing prediction equations.
Data from 369 measurements were included in the formula design. Only weight and diagnosis influenced energy expenditure significantly. Three formulas (A, B, C) with an R² > 0.8 were developed. When we compared the new formulas with commonly used equations (Schofield, Food and Agriculture Organization/World Health Organization/United Nations University, and White equation), all formulas performed very similar, but the Schofield equation seemed to have the lowest SD.
All 3 new pediatric intensive care unit equations have R² values of > 0.8; however, the Schofield equation still performed better than other predictive methods in predicting energy expenditure in these patients. Still, none of the predictive equations, including the new equations, predicted energy expenditure within a clinically accepted range, and further research is required, particularly for patients outside the technical scope of indirect calorimetry.
传统上，能量需求是通过预测方程来计算的。这些方法未能准确计算能量消耗。常规间接测热法已被提出，但该方法技术要求高且成本高。本研究旨在开发一种新的预测方程来估计危重症儿童的能量需求。
这项对接受机械通气的儿童进行的前瞻性观察性研究包括气管内管泄漏<10%和吸入氧分数<60%的患者。进行了间接测热法能量消耗测量，并使用多项式回归分析来开发新的预测方程。然后将新公式与现有的预测方程进行比较。
公式设计中包含了 369 次测量的数据。只有体重和诊断对能量消耗有显著影响。开发了三个 R²>0.8 的公式（A、B、C）。当我们将新公式与常用公式（Schofield、粮农组织/世界卫生组织/联合国大学和 White 公式）进行比较时，所有公式的表现都非常相似，但 Schofield 公式的标准差似乎最低。
所有 3 个新的儿科重症监护病房方程的 R²值均>0.8；然而，在预测这些患者的能量消耗方面，Schofield 方程仍然优于其他预测方法。尽管如此，包括新方程在内的所有预测方程都未能在临床可接受的范围内预测能量消耗，需要进一步研究，特别是对于间接测热法技术范围之外的患者。
