Quebbeman E J, Ausman R K, Schneider T C
Ann Surg. 1982 Mar;195(3):282-6. doi: 10.1097/00000658-198203000-00007.
Nutritional support regimens are currently based on estimates of energy expenditure, and these estimates are then increased substantially in patients with severe trauma or sepsis because of a presumed hypermetabolic state. Forty-four patients on parenteral nutrition were evaluated using indirect calorimetry to measure actual energy expenditure, and an attempt was made to correlate metabolic rate with clinical diagnosis. We found no statistical difference in metabolic rates between groups of patients classified as malnourished, stressed, or catabolic, If high levels of nonprotein energy substrates are to be administered to a catabolic or "hypermetabolic" patient group, the justification must be on a basis other than a significant increase in actual rate of energy expenditure.
目前，营养支持方案是基于能量消耗的估计值制定的，由于假定存在高代谢状态，这些估计值在严重创伤或脓毒症患者中会大幅提高。对44例接受肠外营养的患者使用间接测热法测量实际能量消耗，并尝试将代谢率与临床诊断相关联。我们发现，在被分类为营养不良、应激或分解代谢的患者组之间，代谢率没有统计学差异。如果要给分解代谢或“高代谢”患者组给予高水平的非蛋白能量底物，其依据必须基于实际能量消耗率的显著增加以外的其他因素。
