Weissman C, Kemper M, Elwyn D H, Askanazi J, Hyman A I, Kinney J M
Chest. 1986 Feb;89(2):254-9. doi: 10.1378/chest.89.2.254.
This study characterizes the pattern of caloric expenditure of a group of 19 mechanically ventilated critically ill patients after surgery. Continuous measurements of metabolic rate were used to examine the total energy expended over an eight-hour period (10 AM to 6 PM) on 21 occassions. This allowed for determination of the energy expended during activity, rest, and sleep. The patients were observed to be resting, defined as lying motionless with eyes open and responsive to surrounding events, for 44 +/- 4 percent (SE) of the studied period. Sleeping, a state where the patient was not aroused by surrounding events, was observed for 17 +/- 3 percent of the studied period. Total energy expenditure was 4.8 +/- 1.8 percent greater than resting energy expenditure (REE). The REE was 13.1 +/- 2.3 percent above sleeping energy expenditure (awakeness factor), while activity energy expenditure was 17.1 +/- 2.9 percent above REE (activity factor). The respiratory quotient (RQ) during activity in the 15 patients receiving infusions of physiologic saline solution or 5 percent dextrose solution was significantly less (p less than 0.02) than the RQ during rest. This appears to be due to increased fat oxidation during activity.
本研究描述了一组19例术后接受机械通气的危重症患者的热量消耗模式。在21个时间段内，连续测量代谢率以检查8小时期间（上午10点至下午6点）消耗的总能量。这使得能够确定活动、休息和睡眠期间消耗的能量。观察到患者在研究期间有44±4%（标准误）的时间处于休息状态，即躺着不动，眼睛睁开，对周围事件有反应。睡眠状态（患者不被周围事件唤醒）在研究期间占17±3%。总能量消耗比静息能量消耗（REE）高4.8±1.8%。REE比睡眠能量消耗高13.1±2.3%（觉醒因子），而活动能量消耗比REE高17.1±2.9%（活动因子）。在15例接受生理盐水或5%葡萄糖溶液输注的患者中，活动期间的呼吸商（RQ）显著低于休息期间（p<0.02）。这似乎是由于活动期间脂肪氧化增加所致。
