Rodriguez D J, Sandoval W, Clevenger F W
Department of Surgery, University of New Mexico, Albuquerque 87131, USA.
J Surg Res. 1995 Oct;59(4):455-9. doi: 10.1006/jsre.1995.1191.
A common method for calculating energy needs (PEE) in acute trauma patients is multiplying the Harris-Benedict equation (BEE) by activity factors (AF) and variable stress factors (SF) depending on the injury severity. Selection of the SF can be an arbitrary and potentially inaccurate decision. The purposes of this study were: (1) to investigate the relationship between injury severity score (ISS) to postinjury energy expenditure (MEE), and (2) to compare the MEE to PEE when using the SF of 1.75. Thirty-five severely injured patients (mean ISS = 27.5 +/- 10.7 SD) admitted to our Level I Trauma Center of the University of New Mexico were prospectively assessed for energy needs [PEE = BEE x 1.2(AF) x 1.75(SF)] and ISS. Total nutritional support delivered estimated needs. Indirect calorimetry measurements were obtained on all of the patients within the first 7-10 days following injury. No correlation (r = -0.042) existed between the MEE and ISS. There was a significant correlation (r = 0.772, P < 0.05) between PEE and MEE when using the SF of 1.75 for all of the patients. These results suggest that there is not a correlation between ISS and subsequent MEE in major trauma patients. In addition, using the SF of 1.75 will closely estimate energy needs in acute trauma patients.
计算急性创伤患者能量需求（PEE）的常用方法是将哈里斯-本尼迪克特方程（BEE）乘以活动系数（AF）和取决于损伤严重程度的可变应激系数（SF）。应激系数的选择可能是随意的，而且可能不准确。本研究的目的是：（1）调查损伤严重程度评分（ISS）与伤后能量消耗（MEE）之间的关系，以及（2）在使用1.75的应激系数时，比较MEE和PEE。对入住新墨西哥大学一级创伤中心的35例重伤患者（平均ISS = 27.5 +/- 10.7 SD）进行前瞻性评估，以确定其能量需求[PEE = BEE x 1.2（AF）x 1.75（SF）]和ISS。提供的总营养支持量估计了需求。在伤后的前7至10天内，对所有患者进行了间接测热法测量。MEE与ISS之间不存在相关性（r = -0.042）。当对所有患者使用1.75的应激系数时，PEE与MEE之间存在显著相关性（r = 0.772，P < 0.05）。这些结果表明，在严重创伤患者中，ISS与随后的MEE之间不存在相关性。此外，使用1.75的应激系数将能密切估计急性创伤患者的能量需求。
