De Cosmi V, Mehta N M, Boccazzi A, Milani G P, Esposito S, Bedogni G, Agostoni C
a Pediatric Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Laboratorio di Statistica Medica, Biometria ed Epidemiologia 'G.A. Maccacaro' Department of Clinical Sciences and Community Health , University of Milan , Milan , Italy.
b Division of Critical Care Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine , Boston Children's Hospital, Boston, Massachusetts; Center for Nutrition, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School , Boston , MA , USA.
Int J Food Sci Nutr. 2017 May;68(3):378-383. doi: 10.1080/09637486.2016.1245714. Epub 2016 Oct 28.
Nutrition has a coadjuvant role in the management of children with acute diseases. We aimed to examine nutritional status, macronutrient requirements and actual macronutrient delivery in bronchiolitis. The nutritional status was classified according to WHO criteria and resting energy expenditure (MREE) was measured using an indirect calorimeter. Bland-Altman analysis was used to examine the agreement between MREE and estimated energy expenditure (EEE) with standard equations. Based on the ratio MREE/EEE in relation to Schofield equation on admission, we defined the subjects' metabolic status. A total of 35 patients were enrolled and 46% were malnourished on admission, and 25.8% were hypermetabolic, 37.1% hypometabolic and 37.1% normometabolic. We performed a 24-h recall in 10 children and 80% were overfed (AEI: MREE >120%). Mean bias (limits of agreement) with MREE was 8.9 (-73.9 to 91.8%) for Schofield; 61.0 (-41 to 163%) for Harris-Benedict; and 9.9 (-74.4 to 94.2%) for FAO-WHO equation. Metabolism of infants with bronchiolitis is not accurately estimated by equations.
营养在急性病患儿的治疗中起辅助作用。我们旨在研究细支气管炎患儿的营养状况、常量营养素需求及实际常量营养素供给情况。根据世界卫生组织标准对营养状况进行分类，并使用间接测热法测量静息能量消耗（MREE）。采用Bland-Altman分析，通过标准方程检验MREE与估计能量消耗（EEE）之间的一致性。根据入院时MREE/EEE与Schofield方程的比值，确定受试者的代谢状态。共纳入35例患者，入院时46%存在营养不良，25.8%为高代谢，37.1%为低代谢，37.1%为正常代谢。我们对10名儿童进行了24小时回顾调查，80%存在喂养过度（AEI：MREE＞ 120%）。Schofield方程与MREE的平均偏差（一致性界限）为8.9（-73.9至91.8%）；Harris-Benedict方程为61.0（-41至163%）；粮农组织-世界卫生组织方程为9.9（-74.4至94.2%）。方程无法准确估计细支气管炎婴儿的代谢情况。
