Intensive Care Unit, Gunma University Hospital, Japan.
Intensive Care Unit, Gunma University Hospital, Japan.
J Crit Care. 2020 Apr;56:236-242. doi: 10.1016/j.jcrc.2020.01.021. Epub 2020 Jan 17.
Estimating nutrient consumption and administering appropriate nutritional therapy is essential for improving clinical outcomes in critically ill patients. Various equations, such as the Harris-Benedict equation, have been developed to estimate the required calories. Previous equations, however, targeted Westerners, whose physical characteristics are likely different from those of Asians. Hence, it is unclear whether these equations can be used for Asian patients. This study focused specifically on sepsis patients admitted to a single Japanese ICU, and aimed to develop novel equations to estimate their total energy expenditure. A total of 95 sepsis patients were included in this study. We measured resting energy expenditure (REE) by using indirect calorimetry, and created equations to calculate basal metabolic rate (BMR) using height, weight and age as variables. REE was predicted by multiplying BMR by the novel equation with the stress factor of 1.4. The prediction error of our novel equations were smaller than those of other conventional equations. We further confirmed the accuracy of our equations and that they were unaffected by patient age and disease severity by using data obtained from another patient group. The current study suggested that these equations might allow accurate estimation of the total energy expenditure and proper management of nutritional therapy in Asian sepsis patients.
估算营养摄入量并给予适当的营养治疗对于改善危重症患者的临床结局至关重要。已经开发了各种方程式，如 Harris-Benedict 方程式，以估算所需的卡路里。然而，以前的方程式针对的是西方人，他们的身体特征可能与亚洲人不同。因此，这些方程式是否适用于亚洲患者尚不清楚。本研究专门针对入住日本单个 ICU 的败血症患者，并旨在开发新的方程式来估算他们的总能量消耗。共有 95 名败血症患者纳入本研究。我们使用间接量热法测量静息能量消耗（REE），并创建了使用身高、体重和年龄作为变量来计算基础代谢率（BMR）的方程式。REE 通过将 BMR 乘以应激系数为 1.4 的新方程式来预测。我们的新方程式的预测误差小于其他传统方程式。我们进一步通过使用另一组患者的数据证实了我们的方程式的准确性，并且它们不受患者年龄和疾病严重程度的影响。本研究表明，这些方程式可能可以准确估算亚洲败血症患者的总能量消耗并进行适当的营养治疗管理。
