Nutrition Department, The Alfred Hospital, Melbourne, Australia.
School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.
JPEN J Parenter Enteral Nutr. 2020 Aug;44(6):1144-1149. doi: 10.1002/jpen.1791. Epub 2020 Feb 6.
This study aimed to compare recommendations in the American Society for Parenteral and Enteral Nutrition (ASPEN) Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient with measured energy expenditure in obese, critically ill adults.
After enrollment, measured energy expenditure was attempted at baseline and twice weekly to extubation or day 14. Data are reported as median [interquartile range].
Twenty patients were included. The median baseline and subsequent measured energy expenditures were 2438 [1807-2703] kcal and 2919 [2318-3362] kcal, respectively. Baseline measured energy expenditures were -491 [-788 to -323] kcal lower than subsequent measurements, and week 1 measurements were lower than those of week 2. The median bias between the guideline recommendation of 11-14 kcal/kg of actual body weight and measured expenditure at baseline was -950 [-1254 to -595] kcal/d and -1618 [-1820 to -866] kcal/d at subsequent measurements.
Clinically significant variation was observed between measured expenditure and guideline recommendations at all time points.
本研究旨在比较美国肠外肠内营养学会（ASPEN）成人危重症患者营养支持治疗的提供和评估指南中的推荐意见与肥胖危重症成人测量能量消耗的情况。
入组后，在基线和拔管或第 14 天之前，每周测量两次能量消耗。数据以中位数[四分位间距]表示。
共纳入 20 例患者。中位基线和随后的测量能量消耗分别为 2438[1807-2703]千卡和 2919[2318-3362]千卡。基线测量的能量消耗比后续测量低 491[788-323]千卡，第 1 周的测量值低于第 2 周。指南建议的 11-14 千卡/公斤实际体重与基线测量支出之间的中位偏差为-950[-1254 至-595]千卡/天，后续测量为-1618[-1820 至-866]千卡/天。
在所有时间点，测量的支出与指南建议之间均存在显著差异。
