[1]翟溶凡,言彩红.新型能量代谢预测公式与 IC 法测定老年重症病人能量代谢的一致性研究[J].肠外与肠内营养杂志,2023,(04):234-238243.[doi:DOI : 10.16151/j.1007-810x.2023.04.007]
　ZHAI Rong-fan,YAN Cai-hong.Consistency study of the new prediction formula and indirectcalorimetry for measuring energy expenditure of elderly patients withcritical illness[J].PARENTERAL & ENTERAL NUTRITION,2023,(04):234-238243.[doi:DOI : 10.16151/j.1007-810x.2023.04.007]
点击复制

新型能量代谢预测公式与 IC 法测定老年重症病人能量代谢的一致性研究()
分享到：

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2023年04期
页码:
234-238243
栏目:
论著
出版日期:
2023-08-10

文章信息/Info

Title:
Consistency study of the new prediction formula and indirectcalorimetry for measuring energy expenditure of elderly patients withcritical illness
作者:
翟溶凡; 言彩红
南华大学衡阳医学院附属第二医院重症医学科，湖南衡阳 421001
Author(s):
ZHAI Rong-fan;  YAN Cai-hong
Department of Critical Care Medicine, The second affiliated Hospital, Hengyang Medical School,University of South China, Hengyang 421001, Hunan, China
关键词:
老年重症 ; 能量代谢 ; IC 法 ; 预测公式
Keywords:
Elderly critically ill patients;  Energy expenditure;  Indirect calorimetry;  Prediction formula
分类号:
R459.3
DOI:
DOI : 10.16151/j.1007-810x.2023.04.007
文献标志码:
A
摘要:
目的：验证间接测热法（IC）与新型预测公式测定老年重症病人静息能量代谢值的一致性，为这种新型基于 APACHE II 评分的能量代谢预测公式应用于临床提供依据。 方法：观察对象为南华大学衡阳医学院附属第二医院重症医学科 2020 年 1 月至 2020 年 7 月期间诊治的 102 名老年重症病人。笔者前期研究的新型预测公式REE=(1.003+APACHE II×0.016)×HB，其经由一元回归对同 APACHE II 评分有关的 HB 法应激系数进行拟合所得。使用 IC 法测量病人入 ICU 后第 1、3、5、7 天的全天静息能量代谢值，将入 ICU 后第 1 天 IC 法测量值作为“金标准”与新型预测公式计算值进行对比，两种测量方式用 Bland-Altman 法进行一致性评价；将 28 d 预后、是否发生院内感染作为结局预测指标，两种方法的预测价值采用受试者工作特征曲线（ROC 曲线）检验其是否存在差异。 结果：IC法测定的入 ICU 后第 1、3、5、7 天的全天静息能量代谢值[(1 781.5 ± 261.2) kcal/d、(1 728.8 ± 260.8) kcal/d、(1 824.5 ±265.6) kcal/d、(1 749.1 ± 267.4) kcal/d，F＝2.459，P ＝ 0.062]，差异无统计学意义，提示病人入 ICU 后 1 周内能量代谢值无较大波动。将 IC 法测量值与新型预测公式计算值进行比较[(1 781.5 ± 261.2) kcal/d vs (1 801.1 ± 218.5) kcal/d]，差异无统计学意义（P > 0.05）；Bland-Altman 分析显示，两种方法一致性较好；ROC 曲线分析结果显示两种方法对 28 天预后及院感的预测价值基本一致（P > 0.05）差异无统计学意义。 结论：间接测热法（IC）与新型预测公式测定的静息能量代谢值一致性较高，可以使用该方法预测老年重症病人静息能量代谢的目标值。
Abstract:
Objective: To verify the consistency of a novel prediction formula with indirect calorimetry (IC) forthe determination of resting energy expenditure in elderly critically ill patients, and to provide a basis for the clinicalapplication of this novel prediction formula based on the APACHE II score. Methods: The subjects were 102 elderlycritically ill patients admitted to Department of Critical Care Medicine, Second Hospital of South China Universitybetween January 2020 and July 2020. The novel prediction formula: REE = (1.003+APACHE II×0.016) × HB, whichwas obtained by fitting the HB method stress coefficient related to the APACHE II score by one-dimensional regression.The IC method was used to measure the resting energy expenditure of patients on days 1, 3, 5, 7 after ICU admission,and the IC method values on day 1 were used as the "gold standard" for comparison with the values calculated by thenew prediction formula. The prognosis at 28 days and the incidence of nosocomial infection were used as predictors ofoutcome, and the predictive value of the two methods was examined by using the receiver operating characteristic curve (ROC curve) Results: The differences in the resting energy expenditure values [(1 781.5 ± 261.2) kcal/d, (1 728.8 ±260.8) kcal/d, (1 824.5 ± 265.6) kcal/d, (1 749.1 ± 267.4) kcal/d, F = 2.459, P = 0.062] measured by the IC method for1,3, 5, 7 days after ICU admission were not statistically significant, suggesting that there were no major fluctuations inenergy expenditure values during the week after ICU admission. Comparing the measured values of IC method with thecalculated values of the new prediction formula [(1 781.5 ± 261.2) kcal/d vs (1 801.1 ± 218.5) kcal/d], the difference wasnot statistically significant (P > 0.05); Bland-Altman analysis showed that the two methods were in good agreement; theresults of ROC curve analysis showed that the predictive value of the two methods for 28-day prognosis and nosocomialinfection were comparable. Conclusion: There is consistency between the indirect calorimetry (IC) method and thenovel prediction formula in examining resting energy expenditure , and the novel method can be used to predict the targetvalues of resting energy expenditure in elderly critically ill patients.

参考文献/References:


[1] Ji T, Zhang L, Han R, et al. Management of Malnutrition Basedon Multidisciplinary Team Decision-Making in Chinese OlderAdults (3M Study): A Prospective, Multicenter, Randomized,Controlled Study Protocol. Front Nutr, 2022, 9:851590.
[2] Kuzuya M. Nutritional Management of Sarcopenia and FrailtyShift from Metabolic Syndrome to Frailty. J Nutr Sci Vitaminol(Tokyo), 2022, 68(Supplement):S67-S69.
[3] Bendavid I, Lobo DN, Barazzoni R, et al. The centenary of theHarris-Benedict equations: How to assess energy requirementsbest Recommendations from the ESPEN expert group. Clin Nutr,2021, 40(3):690-701.
[4] Achamrah N, Delsoglio M, De Waele E, et al. Indirectcalorimetry: The 6 main issues. Clin Nutr, 2021, 40(1):4-14.
[5] 翟溶凡,言彩红 . 基于 APACHE Ⅱ评分的老年重症病人能量代谢预测公式 . 肠外与肠内营养,2022,29(3):146-149 .
[6] De Waele E, Honoré PM, Malbrain MLNG. Does the use ofindirect calorimetry change outcome in the ICU? Yes it does.Curr Opin Clin Nutr Metab Care, 2018, 21(2):126-129.
[7] Luy SC, Dampil OA. Comparison of the Harris-BenedictEquation, Bioelectrical Impedance Analysis, and IndirectCalorimetry for Measurement of Basal Metabolic Rate amongAdult Obese Filipino Patients with Prediabetes or Type 2Diabetes Mellitus. J ASEAN Fed Endocr Soc, 2018, 33(2):152-159.
[8] Pourhassan M, Daubert D, Wirth R. Measured and PredictedResting Energy Expenditure in Malnourished Older HospitalizedPatients: A Cross-Sectional and Longitudinal Comparison.Nutrients, 2020, 12(8):2240.
[9] Honore PM, Redant S, Preseau T, et al. Indirect calorimetry is thegold standard to assess REE in ICU patients: some limitations toconsider. Crit Care, 2021, 25(1):406.
[10] Valainathan S, Boukris A, Arapis K, et al. Energy expenditure inacute pancreatitis evaluated by the Harris-Benedict equationcompared with indirect calorimetry. Clin Nutr ESPEN, 2019, 10(33):57-59.
[11] 方 淼,郑 涛,黄金健,等 . 脓毒症休克病人早期营养支持 . 肠外与肠内营养,2019,26(2):119-123.
[12] Preiser JC, Ichai C, Orban JC, et al. Metabolic response to thestress of critical illness. Br J Anaesth, 2014, 113(6): 945-954.
[13] Chen Q, Tang W, Shao X, et al. Analysis of the differencebetween indirect calorimetry and predicted energy estimation inpatients with chronic obstructive pulmonary disease. Zhong huaWei Zhong Bing Ji Jiu Yi Xue, 2018, 30(3):257-261.
[14] Sousa G, Mendes I, Tavares L, et al. Indirect Calorimetry as anInstrument of Research to Identify the Effect of Hypermetabolismin Critical Patients’ Prognosis. Cureus, 2021, 13(9):e17784.

相似文献/References:

[1]翟溶凡,言彩红.基于 APACHE II 评分的老年重症病人能量代谢预测公式[J].肠外与肠内营养杂志,2022,(03):146.[doi:DOI : 10.16151/j.1007-810x.2022.03.004]
　ZHAI Rong-fan,YAN Cai-hong.A APACHE II score-based prediction formula of energy metabolism in critically ill elderly patients[J].PARENTERAL & ENTERAL NUTRITION,2022,(04):146.[doi:DOI : 10.16151/j.1007-810x.2022.03.004]

备注/Memo

备注/Memo:
基金项目 ：湖南省卫生健康委员会临床研究项目(20201968)作者简介 ：翟溶凡，主治医师，医学硕士研究生，从事重症医学专业。E-mail：250511925@qq.com通讯作者 ：言彩红，E-mail：27593247@qq.com
更新日期/Last Update: 1900-01-01