Pharmacy School, Food of Science Program, UFMG, Belo Horizonte, Minas Gerais, Brazil.
Nursing School, Department of Nutrition, UFMG, Belo Horizonte, Minas Gerais, Brazil.
JPEN J Parenter Enteral Nutr. 2021 Jan;45(1):152-157. doi: 10.1002/jpen.1825. Epub 2020 Apr 7.
Nutrition therapy plays a major role in the perioperative management of surgical patients. Understanding energy metabolism and correctly establishing the adequate energy needs is a crucial step to provide optimal nutrition care. The aim of this study was to assess the resting energy expenditure (REE) after major abdominal procedures and its associated factors.
This was a prospective observational study conducted at a single center. REEs of patients admitted for gastrointestinal surgical procedures were measured by indirect calorimetry 24 hours prior to the procedure and reassessed at least once within the fifth postoperative day. Substrate oxidation was calculated according to the Frayn equation. Nutrition status was evaluated using subjective global assessment.
There were no significant changes in the REEs throughout the study period; however, there was a decrease in the respiratory quotient during the postoperative period, as well as a decrease in carbohydrate oxidation and an increase in lipid oxidation. Only 33.3% of the patients presented a postoperative increase in REE > 10%. Those patients presented higher blood-monocyte levels.
Postoperative REE is not increased in most of the patients. In patients who had increased REE, associated factors included higher levels of monocytes.
营养疗法在外科患者围手术期管理中起着重要作用。了解能量代谢并正确确定足够的能量需求是提供最佳营养护理的关键步骤。本研究旨在评估腹部大手术后的静息能量消耗（REE）及其相关因素。
这是一项在单中心进行的前瞻性观察性研究。在手术前 24 小时通过间接测热法测量接受胃肠道手术的患者的REE，并在术后第 5 天内至少重新评估一次。根据 Frayn 方程计算底物氧化。使用主观整体评估来评估营养状况。
在整个研究期间，REE 没有明显变化；然而，在术后期间呼吸商下降，碳水化合物氧化减少，脂质氧化增加。只有 33.3%的患者术后 REE 增加>10%。这些患者的血单核细胞水平较高。
大多数患者术后 REE 没有增加。在 REE 增加的患者中，相关因素包括单核细胞水平较高。
