1 Department of Anaesthesiology and Intensive Care, Karolinska University Hospital Huddinge, CLINTEC, Clinical Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
2 Gastrocentrum, Department of Surgery, Karolinska University Hospital Huddinge, CLINTEC, Clinical Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
JPEN J Parenter Enteral Nutr. 2017 Aug;41(6):976-980. doi: 10.1177/0148607116633808. Epub 2016 Mar 15.
Indirect calorimetry (IC) is the gold standard for determining energy expenditure in patients requiring mechanical ventilation. Metabolic armbands using data derived from dermal measurements have been proposed as an alternative to IC in healthy subjects, but their utility during critical illness is unclear. The aim of this study was to determine the level of agreement between the SenseWear armband and the Deltatrac Metabolic Monitor in mechanically ventilated intensive care unit (ICU) patients.
Adult ICU patients requiring invasive ventilator therapy were eligible for inclusion. Simultaneous measurements were performed with the SenseWear Armband and Deltatrac under stable conditions. Resting energy expenditure (REE) values were registered for both instruments and compared with Bland-Altman plots.
Forty-two measurements were performed in 30 patients. The SenseWear Armband measured significantly higher REE values as compared with IC (mean bias, 85 kcal/24 h; P = .027). Less variability was noted between individual SenseWear measurements and REE as predicted by the Harris-Benedict equation (2 SD, ±327 kcal/24 h) than when IC was compared with SenseWear and Harris-Benedict (2 SD, ±473 and ±543 kcal/24 h, respectively).
The systematic bias and large variability of the SenseWear armband when compared with gas exchange measurements confer limited benefits over the Harris Benedict equation in determining caloric requirements of ICU patients.
间接热量测定法（IC）是确定需要机械通气的患者能量消耗的金标准。利用皮肤测量值得出数据的代谢臂带已被提议作为健康受试者 IC 的替代方法，但在危重病患者中的实用性尚不清楚。本研究的目的是确定在接受机械通气的重症监护病房（ICU）患者中，SenseWear 臂带与 Deltatrac 代谢监测仪之间的一致性水平。
符合条件的 ICU 成年患者需要接受有创呼吸机治疗。在稳定条件下同时使用 SenseWear 臂带和 Deltatrac 进行测量。为两种仪器记录静息能量消耗（REE）值，并与 Bland-Altman 图进行比较。
在 30 名患者中进行了 42 次测量。与 IC 相比，SenseWear 臂带测量的 REE 值明显更高（平均偏差，85 kcal/24 h；P =.027）。与 IC 相比，SenseWear 与 Harris-Benedict 方程（2 SD，±327 kcal/24 h）之间的个别 SenseWear 测量值与 REE 之间的差异较小（2 SD，±473 和±543 kcal/24 h）。
与气体交换测量值相比，SenseWear 臂带的系统偏差和较大的变异性在确定 ICU 患者的热量需求方面，与 Harris Benedict 方程相比，获益有限。
