Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China,
Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Ann Nutr Metab. 2021;77(5):271-278. doi: 10.1159/000518676. Epub 2021 Sep 15.
Several predictive equations have been used to estimate patients' energy expenditure. The study aimed to describe the characteristics of resting energy expenditure (REE) in patients undergoing mechanical ventilation during early postoperative stage after cardiac surgery and evaluate the validity of 9 REE predictive equations.
This was a prospective observational study. Patients aged 18-80 years old, undergone open-heart surgery, were enrolled between January 2017 and 2018. The measured REE (mREE) was evaluated via indirect calorimetry (IC). The predictive resting energy expenditure (pREE) was suggested by 9 predictive equations, including Harris-Benedict (HB), HB coefficient method, Ireton-Jones, Owen, Mifflin, Liu, 25 × body weight (BW), 30 × BW, and 35 × BW. The association between mREE and pREE was assessed by Pearson's correlation, paired t test, Bland-Altman method, and the limits of agreement (LOA).
mREE was related to gender, BMI, age, and body temperature. mREE was significantly correlated with pREE, as calculated by 9 equations (all p < 0.05). There was no significant difference between pREE and mREE, as calculated by 30 × BW kcal/kg/day (t = 0.782, p = 0.435), while significant differences were noted between mREE and pREE calculated by other equations (all p < 0.05). Taking the 30 × BW equation as a suitable candidate, most of the data points were within LOA, and the percentage was 95.6% (129/135). Considering the rationality of clinical use, accurate predictions (%) were calculated, and only 40.74% was acceptable.
The 30 × BW equation is relatively acceptable for estimating REE in 9 predictive equations in the early stage after heart surgery. However, the IC method should be the first choice if it is feasible.
已有多种预测方程被用于估算患者的能量消耗。本研究旨在描述心脏手术后早期机械通气患者静息能量消耗（REE）的特征，并评估 9 种 REE 预测方程的有效性。
这是一项前瞻性观察性研究。纳入 2017 年 1 月至 2018 年期间接受开胸心脏手术的 18-80 岁患者。通过间接测热法（IC）评估实测 REE（mREE）。9 种预测方程（包括 Harris-Benedict[HB]、HB 系数法、Ireton-Jones、Owen、Mifflin、Liu、25×体重[BW]、30×BW 和 35×BW）预测静息能量消耗（pREE）。采用 Pearson 相关、配对 t 检验、Bland-Altman 法和一致性界限（LOA）评估 mREE 与 pREE 之间的关系。
mREE 与性别、BMI、年龄和体温有关。9 种方程计算的 pREE 与 mREE 显著相关（均 p<0.05）。30×BW kcal/kg/day 计算的 pREE 与 mREE 无显著差异（t=0.782，p=0.435），而其他方程计算的 pREE 与 mREE 差异显著（均 p<0.05）。以 30×BW 方程为合适的候选方程，大部分数据点在 LOA 内，占比为 95.6%（129/135）。考虑到临床使用的合理性，计算准确预测率（%），仅 40.74%是可以接受的。
在心脏手术后早期，30×BW 方程在 9 种预测方程中估算 REE 相对可靠。但如果可行，IC 法应作为首选。
