KMID : 0853020070100020107
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Journal of Korean Burn Society 2007 Volume.10 No. 2 p.107 ~ p.111
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Indirect Calorimetry (IC) Use of Massive Burn Patients in ICU
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Ha Tae-Sun
Cho Yong-Suk Kim Do-Hern Hur Jun Chun Wook Kim Jong-Hyun Lee Jae-Jung Park Ji-Young
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Abstract
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Backgrounds: Burns are the most severe form of trauma, massive burn patients require adequate nutritional support for decreasing morbidity and complication. For fitting and monitoring nutritional demand is difficulty due to unreliability of standard parameter. Indirect calorimetry has been utilized repeatedly in burned patients, has been advocated for monitoring the response of individual patients to nutritional support. The purpose of this study was to assess the availability of resting energy expenditure by Indirect calorimetry in the routine monitoring of massive burn patients.
Methods: Eighty-six patients with ¡Ã20% body surface area were monitored with 163 measurement of resting energy expenditure (REE) calculation of respiratory quotient (RQ) from January 2004 to Jan. 2005 in burn center of the Hangang Sacred Heart Hospital. Also measurement weights per week, routine laboratory test were done. This result was compared to five predictive equations: Harris-Benedict equation (basal energy expenditure), Curreri, Milner, Xie, Zawacki.
Results: Mean respiratory quotient was 0.88, corresponding to REE of 1859.55 kcal/day. Measurement of REE were 1.26 times basal energy expenditure (BEE) calculated by the Harris-Benedict equation, and it¡¯s meaning of adequate nutrition. A prediction of Curreri fomula were 2.11 times than MREE, and it¡¯s meaning was overestimating energy enxpenditure significantly. Comparing MREE with Xie, Zawacki & Milner, Milner and Xie were 1.02 (formula/REE) similar to measurement of IC. However Milner is high correlation than Xie in Pearson correlation coefficient. REE varied during hospitalization, increasing on adimission and decreasing as wound healing.
Conclusion: Burn patients are variably hypermetabolic energy expenditure cannot be precisely predicted. Routine use of indirect calorimetry is valuable in the early detection of significant under or over nutrition. If IC is not available, Milner is more better methods than Xie, Zawacki.
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KEYWORD
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Indirect calorimetry, Milner, Xie, Zawacki, Burns
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