Nevin Amy, Mayr Hannah, Atresh Sridhar, Kemp Irene, Simmons Joshua, Vivanti Angela, Hickman Ingrid J
Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Top Spinal Cord Inj Rehabil. 2016 Fall;22(4):269-276. doi: 10.1310/sci2016-00001.
In the absence of reliable predictive equations, indirect calorimetry (IC) remains the gold standard for assessing energy requirements after spinal cord injury (SCI), but it is typically confined to a research setting. The purpose of this study is to assess the feasibility and acceptability of implementing IC into routine clinical care in an Australian SCI rehabilitation facility. Bedside IC (canopy hood) was performed, and patients completed an IC acceptability questionnaire (open-ended; yes/no; 5-point Likert scale). Fasted resting energy expenditure (REE) steady-state criteria were applied to assess data quality, and adherence to a test ≥20 minutes was recorded. Staff were surveyed to assess impact of IC on usual care. Of 35 eligible patients, 9 declined (7 reported claustrophobia). One patient could not be tested before discharge and 25 underwent IC (84% male, injury level C2-L2, AIS A-D). Anxiety prevented one patient from completing IC, while another failed to fast. The remaining 23 patients achieved a steady-state REE (≥5 consecutive minutes with ≤10% coefficient of variation for VO and VCO). Test-retest ( = 5) showed <10% variation in REE. Patients deemed the procedure acceptable, with 88% reporting a willingness to repeat IC. Eighty percent of patients and 90% of staff agreed it was acceptable for IC to be integrated into usual care. This study found that IC is a feasible and acceptable addition to the routine clinical care of patients recovering from SCI and may serve to improve accuracy of nutrition interventions for this patient population.
在缺乏可靠预测方程的情况下，间接测热法（IC）仍是评估脊髓损伤（SCI）后能量需求的金标准，但它通常仅限于研究环境。本研究的目的是评估在澳大利亚一家SCI康复机构将IC应用于常规临床护理的可行性和可接受性。进行了床边IC（ canopy hood）测量，患者完成了一份IC可接受性问卷（开放式；是/否；5级李克特量表）。应用空腹静息能量消耗（REE）稳态标准来评估数据质量，并记录测试持续时间≥20分钟的情况。对工作人员进行了调查，以评估IC对常规护理的影响。在35名符合条件的患者中，9人拒绝（7人报告有幽闭恐惧症）。1名患者在出院前无法进行测试，25人接受了IC测量（84%为男性，损伤平面为C2-L2，美国脊髓损伤协会损伤分级A-D级）。焦虑使1名患者无法完成IC测量，另1名患者未禁食。其余23名患者达到了REE稳态（VO和VCO的变异系数≤10%，连续≥5分钟）。重测（n = 5）显示REE的变异<10%。患者认为该操作可以接受，88%的患者表示愿意重复进行IC测量。80%的患者和90%的工作人员认为将IC纳入常规护理是可以接受的。本研究发现，IC是SCI康复患者常规临床护理中一种可行且可接受的补充方法，可能有助于提高该患者群体营养干预的准确性。
