Coss-Bu J A, Jefferson L S, Levy M L, Walding D, David Y, Klish W J
Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Nutr Clin Pract. 1997 Apr;12(2):81-4. doi: 10.1177/011542659701200281.
Patients with toxic epidermal necrolysis, a severe, exfoliative skin disorder, have clinical features similar to those of partial-thickness burn patients. The literature suggests that they also have similar nutritional requirements. We report two patients diagnosed with toxic epidermal necrolysis on mechanical ventilation, in whom resting energy expenditure and respiratory quotient were measured by indirect calorimetry. The patients were treated using standard burn protocols. Nitrogen balance was calculated by measuring total urinary nitrogen in urine samples obtained over 24 hours. These measurements were done while the patients were on mechanical ventilation and receiving total parenteral nutrition. As in burn patients, early in their course the two patients had resting energy expenditure values twice that predicted. After 12 days of hospitalization, nitrogen balance was negative in patient 1 and positive in patient 2. Energy and protein requirements appear to have been related to the amount of body surface affected.
中毒性表皮坏死松解症是一种严重的剥脱性皮肤病，患有该病的患者具有与部分厚度烧伤患者相似的临床特征。文献表明，他们也有相似的营养需求。我们报告了两名诊断为中毒性表皮坏死松解症且正在接受机械通气的患者，通过间接测热法测量了他们的静息能量消耗和呼吸商。患者采用标准烧伤方案进行治疗。通过测量24小时收集的尿液样本中的总尿氮来计算氮平衡。这些测量是在患者接受机械通气并接受全胃肠外营养时进行的。与烧伤患者一样，在病程早期，这两名患者的静息能量消耗值是预测值的两倍。住院12天后，患者1的氮平衡为负，患者2的氮平衡为正。能量和蛋白质需求似乎与受影响的体表面积有关。
