Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
Novosibirsk State Medical University, Novosibirsk, Russian Federation.
JPEN J Parenter Enteral Nutr. 2018 May;42(4):702-708. doi: 10.1177/0148607117711648. Epub 2017 Dec 19.
This study tested the accuracy of resting energy expenditure (REE) equations among patients who underwent cardiopulmonary bypass and developed/validated a more accurate cardio-specific equation (CSE).
Prospective observational cohort of 240 adults (derivation data set, 170 patients; validation data set, 70 patients). REEs were calculated with 6 equations-Penn State 2003a, Penn State 2003b, Ireton-Jones, Swinamer, Faisy, and American College of Chest Physicians-and results were compared with indirect calorimetry (IC). Multivariable linear regression analysis was used to develop the CSE. Agreement between measured and calculated REEs was assessed with Lin's concordance correlation coefficient (LCCC), Bland-Altman plot, and regression analysis.
LCCCs present poor agreement between measured and calculated REEs: 0.24 (95% CI, 0.19-0.29), for the Faisy equation; 0.15 (95% CI, 0.1-0.19), Ireton-Jones; 0.31 (95% CI, 0.25-0.37), Swinamer; 0.17 (95% CI, 0.13-0.21), Penn State 2003a; 0.19 (95% CI, 0.14-0.23), Penn State 2003b; and 0.11 (95% CI, 0.07-0.15), American College of Chest Physicians. Based on the derivation data set, REEs are explained by the following equation: CSE = 616 - 8 × age in years + 13 × weight in kilograms + 450 if on ventilator + 159 × MV in liters + 145 if on inotropes. Based on the validation study results, the LCCC between IC and the CSE was 0.82 (95% CI, 0.73-0.88).
The CSE has adequate precision and could be used for REE estimation for patients undergoing cardiopulmonary bypass if IC is unavailable.
本研究旨在检验体外循环术后患者使用静息能量消耗（REE）方程的准确性，并验证开发一种更准确的心脏特异性方程（CSE）。
前瞻性观察队列研究纳入 240 例成年人（推导数据集，170 例患者；验证数据集，70 例患者）。使用 6 种方程（宾夕法尼亚州立大学 2003a 年、宾夕法尼亚州立大学 2003b 年、Ireton-Jones、Swinamer、Faisy 和美国胸科医师学会）计算 REE，并与间接热量测定法（IC）进行比较。使用多元线性回归分析建立 CSE。使用 Lin 一致性相关系数（LCCC）、Bland-Altman 图和回归分析评估测量和计算的 REE 之间的一致性。
LCCC 显示测量和计算的 REE 之间的一致性较差：Faisy 方程为 0.24（95%置信区间，0.19-0.29）；Ireton-Jones 为 0.15（95%置信区间，0.1-0.19）；Swinamer 为 0.31（95%置信区间，0.25-0.37）；宾夕法尼亚州立大学 2003a 年为 0.17（95%置信区间，0.13-0.21）；宾夕法尼亚州立大学 2003b 年为 0.19（95%置信区间，0.14-0.23）；美国胸科医师学会为 0.11（95%置信区间，0.07-0.15）。基于推导数据集，REE 可以用以下方程解释：CSE=616-8×年龄（岁）+13×体重（千克）+450（如果使用呼吸机）+159×MV（升）+145（如果使用正性肌力药物）。基于验证研究结果，IC 和 CSE 之间的 LCCC 为 0.82（95%置信区间，0.73-0.88）。
如果无法使用间接热量测定法，CSE 可用于估计体外循环术后患者的 REE，具有足够的精度。
