Raurich Puigdevall J M, Ibáñez Juvé J
Servicio de Medicina Intensiva, Hospital Son Dureta, Palma de Mallorca, España.
Nutr Hosp. 1998 Nov-Dec;13(6):303-8.
The objectives of this study ere to assess the reproducibility of the energy expenditure at rest in patients with mechanical ventilation, using the indirect calorimetry method and the Fick principle, and to verify whether both methods of measuring the energy expenditure, are interchangeable. 15 critically ill patients on mechanical ventilation were studied. Each study consisted of the determination, in duplicate, of the energy expenditure at rest, using indirect calorimetry and the Fick principle. Each patient was studied on two occasions, thus yielding a total of 30 studies. The determination of the energy expenditure at rest using indirect calorimetry was carried out using an apparatus based on the closed circuit method (Calorimet), and the Fick principle was carried out using a thermodilution catheter placed in the pulmonary artery. The reproducibility coefficient of the indirect calorimetry method was 132 kcal/day, which is equivalent to 7% of the average energy expenditure at rest. The reproducibility coefficient of the Fick method was 344 kcal/day, which is equivalent to 18% of the average energy expenditure at rest. The difference between both methods, 6 +/- 50 kcal/day, was not significant. The corresponding limits in both methods were between-306 kcal/day and 294 kcal/day, which is equivalent to 15% of the average energy expenditure at rest.
The determination of the energy expenditure at rest using the Fick method, has a worse reproducibility coefficient that obtained by indirect calorimetry, but from a clinical point of view, both methods are interchangeable.
本研究的目的是使用间接测热法和菲克原理评估机械通气患者静息能量消耗的可重复性，并验证两种测量能量消耗的方法是否可互换。对15名接受机械通气的重症患者进行了研究。每项研究包括使用间接测热法和菲克原理重复测定静息能量消耗。对每位患者进行了两次研究，因此总共进行了30项研究。使用基于闭路法的仪器（Calorimet）通过间接测热法测定静息能量消耗，使用置于肺动脉的热稀释导管运用菲克原理进行测定。间接测热法的可重复性系数为132千卡/天，相当于静息平均能量消耗的7%。菲克法的可重复性系数为344千卡/天，相当于静息平均能量消耗的18%。两种方法之间的差异为6±50千卡/天，无显著性差异。两种方法相应的界限在-306千卡/天至294千卡/天之间，相当于静息平均能量消耗的15%。
使用菲克法测定静息能量消耗的可重复性系数比间接测热法差，但从临床角度来看，两种方法是可互换的。
