Giantin V, Ceccon A, Enzi G, Sergi G, Perini P, Bussolotto M, Schiavon M, Casadei A, Mazzoleni F, Sartori L
Institute of Internal Medicine, Padova, Italy.
JPEN J Parenter Enteral Nutr. 1995 Jan-Feb;19(1):55-62. doi: 10.1177/014860719501900155.
Although frequently done, estimating the energy requirements of individual burn patients without measuring their resting metabolic rate is a less than satisfactory method of evaluation.
We tested whether heart rate, which relates to the energy expenditure during physical activity, is also associated with postburn hypermetabolism (calculated as percentage increase of resting metabolic rate above the predicted normal fasting resting metabolic rate). Twenty-three patients [12 men and 11 women, aged 38 +/- 13 years (mean +/- SD); weight, 71.6 +/- 14.8 kg; body mass index, 25.4 +/- 3.6; total burn surface area, 35.3 +/- 17.8% (percentage of body surface)] were studied weekly for 3 weeks after an overnight fast.
Measured resting metabolic rates and heart rates were 2016 +/- 497 kcal/d, 101 +/- 13 bpm (n = 19); 2231 +/- 485 kcal/d, 107 +/- 13 bpm (n = 18); and 1903 +/- 598 kcal/d, 99 +/- 14 bpm (n = 11) for weeks 1, 2, and 3, respectively. Postburn hypermetabolism was +36% +/- 19%, +55% +/- 27%, and +36% +/- 35% in the first, second, and third week, respectively. In each week postburn hypermetabolism correlated with heart rate (r = 0.65, p = .003; r = 0.69, p = .001; and r = 0.80, p = .002, respectively). Only in the second week did postburn hypermetabolism correlate with total burn surface area (r = 0.52, p = .02); there was no correlation with body temperature. In a multiple regression analysis, predicted resting metabolic rate, heart rate, and total burn surface area together explained 77% of all of the variance observed in the 48 fasting resting metabolic rates that were measured in the study (r2 = 0.77, p < .0001), and each of these variables also had a significant partial correlation with fasting resting metabolic rates (r2 = 0.45, p < .0001; r2 = 0.29, p < .0001; and r2 = 0.03, p < .03, respectively).
In burn patients, variability in heart rate is associated with a significant part of postburn hypermetabolism variability. Therefore, heart rate may be considered a useful variable to be used for the evaluation of the energy requirements of severely burned patients.
尽管经常进行，但在不测量个体烧伤患者静息代谢率的情况下估算其能量需求，是一种不太令人满意的评估方法。
我们测试了与体力活动期间能量消耗相关的心率是否也与烧伤后高代谢相关（计算为静息代谢率高于预测的正常空腹静息代谢率的百分比增加）。对23例患者[12例男性和11例女性，年龄38±13岁（均值±标准差）；体重71.6±14.8 kg；体重指数25.4±3.6；总烧伤表面积35.3±17.8%（体表面积百分比）]在禁食过夜后每周进行3周的研究。
第1、2和3周测量的静息代谢率和心率分别为2016±497千卡/天、101±13次/分钟（n = 19）；2231±485千卡/天、107±13次/分钟（n = 18）；以及1903±598千卡/天、99±14次/分钟（n = 11）。烧伤后高代谢在第一、第二和第三周分别为+36%±19%、+55%±27%和+36%±35%。在烧伤后的每周，高代谢均与心率相关（r = 0.65，p = 0.003；r = 0.69，p = 0.001；以及r = 0.80，p = 0.002）。仅在第二周，烧伤后高代谢与总烧伤表面积相关（r = 0.52，p = 0.02）；与体温无相关性。在多元回归分析中，预测的静息代谢率、心率和总烧伤表面积共同解释了研究中测量的48个空腹静息代谢率中观察到的所有方差的77%（r2 = 0.77，p < 0.0001），并且这些变量中的每一个也与空腹静息代谢率具有显著的偏相关性（r2 = 0.45，p < 0.0001；r2 = 0.29，p < 0.0001；以及r2 = 0.03，p < 0.03）。
在烧伤患者中，心率变异性与烧伤后高代谢变异性的很大一部分相关。因此，心率可被视为用于评估严重烧伤患者能量需求的一个有用变量。
