A comparative study of the respiratory indirect calorimetry and HB coefficient method for the guidance of the target energy in patients with sepsis

Q4 Nursing

中华临床营养杂志 Pub Date : 2019-08-30 DOI:10.3760/CMA.J.ISSN.1674-635X.2019.04.007

Xiaojuan Yang, Jun Zhang, Lijuan Wang

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引用次数: 0

Abstract

Objective To explore the effects of nutritional supports following target energy measured by respiratory indirect calorimetry and HB coefficient method respectively on the nutrition and immune indexes of patients with sepsis. Methods A prospective comparative study of 60 patients with sepsis who was suitable for nutritional support and respiratory indirect calorimetry in the intensive care unit (ICU) of the hospital from January 2015 to October 2015 was conducted. Resting Energy Expenditure (REE) was measured simultaneously by respiratory indirect calorimetry (n=30) and HB coefficient (Harris-Benedict formula×stress coefficient, n=30) in patients with sepsis and the nutritional support was given according to the MREE measured by the two methods. The nutritional and immune indexes were obtained at 0 day, 3 day, 7 day, and 14 day after nutritional support. The nutritional and immune indexes at 0 day were considered as the baseline and the differences in the nutritional and immune indexes between the baseline and 3 day, 7 day and 14 day were expressed as a "Δ". Values of Δ were compared between the two goups. Results With nutritional support for 3 days, Δalbumin, Δ prealbumin, Δthe total T lymphocytes, Δassist/induction of T cells and ΔIgG were higher in the respiratory indirect calorimetry group than in the HB coefficient group (P<0.05). With nutritional support for 7 days, Δalbumin, ΔT lymphocytes, ΔIgM were higher in the respiratory indirect calorimetry group than in the HB coefficient group (P<0.05). With nutritional support for 14 days, Δtransferrin, Δsuppression/cytotoxic T cells, ΔIgG, ΔIgA, ΔC3 andΔC4 were higher in the respiratory indirect calorimetry group than in the HB coefficient group(P<0.05). Conclusion Nutritional support with REE measured by respiratory indirect calorimetry in patients with sepsis is more effective on nutritional and immune related indexes improvement have different degrees of improvement, thus respiratory indirect calorimetry is more suitable to guide the target energy of sepsis patients. Key words: Sepsis; Target energy; Respiratory indirect calorimetry; HB coefficient; Nutrition

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呼吸间接量热法和HB系数法指导败血症患者靶能量的比较研究

目的探讨呼吸间接量热法和HB系数法分别测定目标能量后给予营养支持对脓毒症患者营养和免疫指标的影响。方法对2015年1月至2015年10月在该院重症监护室(ICU)收治的60例适合营养支持及呼吸间接量热法治疗的脓毒症患者进行前瞻性比较研究。采用呼吸间接量热法(n=30)和HB系数(Harris-Benedict formula×stress系数，n=30)同时测量脓毒症患者的静息能量消耗(REE)，并根据两种方法测得的REE给予营养支持。分别于营养支持后第0天、第3天、第7天和第14天测定各组的营养和免疫指标。以第0天的营养和免疫指标为基线，将基线与第3天、第7天、第14天的营养和免疫指标差异用“Δ”表示。比较两组间Δ值。结果营养支持3 d时，呼吸间接量热组患者Δalbumin、Δ前白蛋白、Δthe总T淋巴细胞、Δassist/诱导T细胞和ΔIgG均高于HB系数组(P<0.05)。营养支持7 d时，呼吸间接量热组Δalbumin、ΔT淋巴细胞、ΔIgM高于HB系数组(P<0.05)。营养支持14 d时，呼吸间接量热组患者的Δtransferrin、Δsuppression/细胞毒性T细胞、ΔIgG、ΔIgA、ΔC3 andΔC4均高于HB系数组(P<0.05)。结论呼吸间接量热法测量REE对脓毒症患者的营养支持更有效，对其营养及免疫相关指标的改善均有不同程度的改善，因此呼吸间接量热法更适合指导脓毒症患者的目标能量。关键词:脓毒症;目标能量;呼吸间接量热法;HB系数;营养

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来源期刊

中华临床营养杂志 Nursing-Nutrition and Dietetics

CiteScore

0.20

自引率

0.00%

发文量

2282

期刊介绍： The Chinese Journal of Clinical Nutrition was founded in 1993. It is the first professional academic journal (bimonthly) in my country co-sponsored by the Chinese Medical Association and the Chinese Academy of Medical Sciences to disseminate information on clinical nutrition support, nutrient metabolism, the impact of nutrition support on outcomes and "cost-effectiveness", as well as translational medicine and nutrition research. It is also a professional journal of the Chinese Medical Association's Parenteral and Enteral Nutrition Branch. The purpose of the Chinese Journal of Clinical Nutrition is to promote the rapid dissemination of knowledge on nutrient metabolism and the rational application of parenteral and enteral nutrition, focusing on the combination of multidisciplinary and multi-regional field investigations and clinical research. It mainly reports on nutritional risk screening related to the indications of parenteral and enteral nutrition support, "cost-effectiveness" research on nutritional drugs, consensus on clinical nutrition, guidelines, expert reviews, randomized controlled studies, cohort studies, glycoprotein and other nutrient metabolism research, systematic evaluation of clinical research, evidence-based case reports, special reviews, case reports and clinical experience exchanges, etc., and has a special column on new technologies related to the field of clinical nutrition and their clinical applications.