Masclans J R, Planas M, Porta I, Bermejo B, Padró J, de Latorre F J
Servicio de Medicina Intensiva, Hospital General Universitario Vall d'Hebrón, Barcelona, España.
Nutr Hosp. 1993 May-Jun;8(5):288-94.
We have made a study of the energy requirements of liver transplant patients in the immediate post-operative phase, by comparing different methods. A study of energy use was made with indirect Calorimetry (IC), of calculation of Resting Energy Expenditure (REE) according to Fick's formula modified by Liggett, and of the calculation of basal energy Expenditure (BEE) applying Harris-Benedict's equation (HB). The correlation between the REE calculation using indirect calorimetry and that of BEE using Harris-Benedict (r = 0.7567) did not give a correction factor, applied to the Harris-Benedict formula) (REE by IC/BEE), which was uniform for all patients, oscillating as it did between 1.0 and 1.8. We found no correlation between REE by IC and that calculated using the modified Fick method, nor between the modified Fick method and BEE as calculated by Harris-Benedict. Our conclusion is that, with the IC method as reference to evaluate energy use, the Harris-Benedict calculation appears to be more reliable than that using the modified Fick equation and that, in the group of patients studied, and given the individual variations in the REE ratio calculated by IC and the BEE calculated by HB, we were unable to find a suitable correction factor for them all. IC is therefore the ideal method for evaluating energy use in critical patients in the ICU.
我们通过比较不同方法,对肝移植患者术后即刻的能量需求进行了研究。采用间接测热法(IC)、根据Liggett修正的Fick公式计算静息能量消耗(REE)以及应用Harris-Benedict方程(HB)计算基础能量消耗(BEE),对能量使用情况进行了研究。使用间接测热法计算的REE与使用Harris-Benedict公式计算的BEE之间的相关性(r = 0.7567)未得出一个校正因子(应用于Harris-Benedict公式)(IC法计算的REE/BEE),该因子对所有患者并非统一,而是在1.0至1.8之间波动。我们发现IC法计算的REE与使用修正Fick法计算的REE之间无相关性,修正Fick法与Harris-Benedict计算的BEE之间也无相关性。我们的结论是,以IC法作为评估能量使用的参考,Harris-Benedict计算似乎比使用修正Fick方程更可靠,并且在所研究的患者组中,鉴于IC法计算的REE与HB法计算的BEE的比率存在个体差异,我们无法为所有患者找到一个合适的校正因子。因此,IC是评估ICU中危重症患者能量使用的理想方法。