Green C J, Campbell I T, McClelland P, Hutton J L, Ahmed M M, Helliwell T R, Wilkes R G, Gilbertson A A, Bone J M
University Department of Anaesthesia, Royal Liverpool Hospital, United Kingdom.
Nutrition. 1995 Nov-Dec;11(6):739-46.
Energy intake and energy expenditure, nitrogen intake, and urinary nitrogen excretion (or urea production rates) were measured in 35 intravenously fed patients with multiple organ failure over the course of their illness to determine to what extent nutrient requirements were met despite fluid retention. Energy and nitrogen balance were related to serial measurements of midupper-arm circumference (MAC). The target feeding regimen of 176 kJ (42 kcal)/kg fat-free mass (FFM) was achieved in only three patients and the target of 0.24 g N/kg FFM in only four. Two patterns of change in MAC were noted: a steady decrease with time and no change with time. Serial muscle biopsy data indicated that all the patients were wasting away; the maintenance of MAC in the group with no change over time was due to fluid retention. Abnormal losses were not measured, but energy and nitrogen balance in the group in which arm circumference decreased had no apparent effect on the rate of wasting.
在35例接受静脉营养支持的多器官功能衰竭患者病程中，测量其能量摄入与能量消耗、氮摄入及尿氮排泄（或尿素生成率），以确定尽管存在液体潴留，营养需求在多大程度上得到满足。能量和氮平衡与连续测量的上臂中部周长（MAC）相关。仅3例患者达到了176 kJ（42 kcal）/kg去脂体重（FFM）的目标喂养方案，仅4例患者达到了0.24 g N/kg FFM的目标。观察到MAC有两种变化模式：随时间稳步下降和随时间无变化。连续的肌肉活检数据表明，所有患者均出现消瘦；上臂周长随时间无变化组中MAC得以维持是由于液体潴留。未测量异常丢失量，但上臂周长下降组的能量和氮平衡对消瘦速率无明显影响。
