Osborne B J, Saba A K, Wood S J, Nyswonger G D, Hansen C W
Nutr Clin Pract. 1994 Dec;9(6):241-6. doi: 10.1177/0115426594009006241.
An accurate and reliable method of determining resting energy expenditure in the critical care setting is crucial because inadequate caloric intake and excessive caloric intake are both associated with a number of complications. Energy requirements were determined by three different methods in a group of 25 post-cardiac surgery patients in the intensive care unit. Patients were intubated and had a thermodilution pulmonary artery catheter in place. The first method measured resting energy expenditure by indirect calorimetry. For the second method, the results of blood gases drawn at the same time that indirect calorimetry was measured were used in the Fick equation. In the third method, a registered dietitian assessed each patient by using the Harris-Benedict equation with stress factor modification. Indirect calorimetry was considered the standard with which the other two methods were compared. The results showed that, compared with calorimetry, both the Fick equation and the Harris-Benedict equation underestimated resting energy needs. Statistically, only the difference between the Fick equation method and indirect calorimetry was significant. Clinically, however, both methods seem to have applicability.
在重症监护环境中，一种准确可靠的测定静息能量消耗的方法至关重要，因为热量摄入不足和热量摄入过多均与多种并发症相关。在一组25名入住重症监护病房的心脏手术后患者中，采用三种不同方法测定能量需求。患者均已插管并放置了热稀释肺动脉导管。第一种方法通过间接测热法测量静息能量消耗。第二种方法是将在测量间接测热法的同时采集的血气结果用于Fick方程。第三种方法是由注册营养师通过使用修正应激因素的Harris-Benedict方程对每位患者进行评估。间接测热法被视为用于与其他两种方法进行比较的标准。结果显示，与测热法相比，Fick方程和Harris-Benedict方程均低估了静息能量需求。从统计学角度来看，只有Fick方程法与间接测热法之间的差异具有显著性。然而，从临床角度来看，这两种方法似乎都有适用性。
