Selby A M, McCauley J C, Schell D N, O'Connell A, Gillis J, Gaskin K J
Intensive Care Unit, Children's Hospital, Camperdown, Australia.
Crit Care Med. 1995 Feb;23(2):365-70. doi: 10.1097/00003246-199502000-00024.
To develop indirect calorimetry to enable measurement of energy expenditure in mechanically ventilated children and to assess the effect of endotracheal tube leak on the accuracy of indirect calorimetry measurements.
Prospective, observational study, using a convenience sample.
Tertiary pediatric intensive care unit in a university-associated children's hospital.
Eighteen patients, 3 months to 10 yrs of age, with various diagnoses, and requiring mechanical ventilation.
Patients were intubated and received routine intensive care treatment.
Energy expenditure and respiratory quotient were measured using a new modification to the technique of indirect calorimetry, which includes an assessment of any expired gas lost around the endotracheal tube. Mean energy expenditure was 97% of predicted energy expenditure, but there was great variability between patients, and energy expenditure could not be estimated reliably from predictive equations. The amount of expired gas lost because of gas leak around the endotracheal tube was often a clinically important proportion of total expired gas, and this lost gas could not be predicted by audible endotracheal tube leak.
Measurement of energy expenditure by indirect calorimetry may be useful in the nutritional management of critically ill children. Results may be inaccurate if the gas lost because of leak around uncuffed endotracheal tubes is not taken into account.
开发间接测热法以测量机械通气儿童的能量消耗，并评估气管插管漏气对间接测热法测量准确性的影响。
前瞻性观察性研究，采用便利样本。
一所大学附属医院的三级儿科重症监护病房。
18名年龄在3个月至10岁之间、患有各种疾病且需要机械通气的患者。
患者接受插管并接受常规重症监护治疗。
使用间接测热法技术的一种新改良方法测量能量消耗和呼吸商，该方法包括评估气管插管周围呼出的任何气体损失。平均能量消耗为预测能量消耗的97%，但患者之间存在很大差异，且无法通过预测方程可靠地估计能量消耗。由于气管插管周围漏气而损失的呼出气体量通常在总呼出气体中占临床重要比例，且这种损失的气体无法通过可闻的气管插管漏气来预测。
间接测热法测量能量消耗可能对危重症儿童的营养管理有用。如果未考虑因无套囊气管插管周围漏气而损失的气体，结果可能不准确。
