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不同BMI组危重患者能量需求的 Harris-Benedict 公式估算法

Effects of BMI on the estimation of the energy metabolism of critically ill patients by Harris-Benedict equation

来源期刊: 广州医药 | 51-54 发布时间:2021-11-28 收稿时间:2025/11/13 17:43:43 阅读量:23
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关键词:
BMI静息能量代谢Harris-Benedict公式间接能量测定法危重症患者
BMIResting energy metabolismHarris-Benedict equationIndirect calorimetryCritically ill patients
DOI:
10.3969/j.issn.1000-8535.2020.04.011
收稿时间:
2020-01-15 
修订日期:
 
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引用总数:
0  
目的 探究Harris-Benedict(HB)公式用于估算机械通气的危重症患者能量代谢的准确性,以及不同BMI分组对其影响。方法 使用间接能量测定法测量患者的静息能量(ICREE),通过HB公式计算其静息能量代谢估算值(HBREE)。将80例患者按BMI分为4组,并通过配对样本t检验对ICREE与HBREE进行比较,Pearson分析用于分析ICREE与HBREE的相关性。结果 共纳入80例机械通气的危重症患者。除肥胖组外的其余各组病人,ICREE均高于HBREE(均P<0.01),HB公式的准确率为23.75%。ICREE与HBREE相关性差(r=0.331,P<0.01)。当各组使用校正系数对HB公式进行调整后,ICREE与HBREE差异无统计学意义,准确率提高至38.8%。结论 使用HB公式不能很好地反应危重症患者的实际能量代谢。BMI可能是影响HB公式准确性的重要因素。依据不同BMI分组,使用相应校正系数可提高HB公式的准确性。
Objective To explore the accuracy of the Harris-Benedict (HB) formula used to estimate the energy metabolism in critically ill patients undergoing mechanical ventilation and the effects of different BMI groups on it. Methods Indirect calorimetry was used to measure the resting energy of the patient,and the estimated resting energy metabolism was calculated by the HB formula. 80 patients were divided into four groups according to BMI. ICREE and HBREE were compared by paired sample t test. Pearson analysis was used to analyze the correlation between ICREE and HBREE. Results This study included 80 critically ill patients undergoing mechanical ventilation.Except for the obese group,ICREEE was higher than HBREE in all patients and the remaining groups of patients. The accuracy rate of the HB formula was 23.75%. The correlation between ICREE and HBREE is poor(r=0.331,P<0.01). There was no statistical difference between ICREEE and HBREE and the accuracy rate increased to 38.8% after the Harris-Benedict equation was adjusted by using the correction factor. Conclusion Using the HB formula can not reflect the actual energy metabolism of critically ill patients well. BMI may be an important factor affecting the accuracy of HB formula. The accuracy of the HB equation can be improved by using different correction factors according to different BMI groupings.
1、 CASAER M P, GREET V D B. Nutrition in the acute phase of critical illness [J]. N Engl J Med, 2014, 370(25): 2450. CASAER M P, GREET V D B. Nutrition in the acute phase of critical illness [J]. N Engl J Med, 2014, 370(25): 2450.
2、 ZUSMAN O, THEILLA M, COHEN J, et al. Resting energy expenditure, calorie and protein consumption in critically ill patients: a retrospective cohort study [J]. Crit care, 2016, 20(1): 367. ZUSMAN O, THEILLA M, COHEN J, et al. Resting energy expenditure, calorie and protein consumption in critically ill patients: a retrospective cohort study [J]. Crit care, 2016, 20(1): 367.
3、 SINGER P, HIESMAYR M, BIOLO G, et al. Pragmatic approach to nutrition in the ICU: Expert opinion regarding which calorie protein target [J]. Clin Nutr, 2014, 33(2): 246-251. SINGER P, HIESMAYR M, BIOLO G, et al. Pragmatic approach to nutrition in the ICU: Expert opinion regarding which calorie protein target [J]. Clin Nutr, 2014, 33(2): 246-251.
4、 HSU P H, LEE C-H, KUO L-K, et al. Determination of the energy requirements in mechanically ventilated critically ill elderly patients in different BMI groups using the Harris-Benedict equation [J]. J Formos Med Assoc, 2018, 117(4): 301-307. HSU P H, LEE C-H, KUO L-K, et al. Determination of the energy requirements in mechanically ventilated critically ill elderly patients in different BMI groups using the Harris-Benedict equation [J]. J Formos Med Assoc, 2018, 117(4): 301-307.
5、 MCCLAVE S A,MARTINDALE R G,LASZLO K. The use of indirect calorimetry in the intensive care unit [J]. Curr Opin Clin Nutr Metab Care,2013,16(2): 202-208. MCCLAVE S A,MARTINDALE R G,LASZLO K. The use of indirect calorimetry in the intensive care unit [J]. Curr Opin Clin Nutr Metab Care,2013,16(2): 202-208.
6、 ISMAEL S, SAVALLE M, TRIVIN C, et al. The consequences of sudden fluid shifts on body composition in critically ill patients [J]. Crit Care, 2014, 18(2): R49. ISMAEL S, SAVALLE M, TRIVIN C, et al. The consequences of sudden fluid shifts on body composition in critically ill patients [J]. Crit Care, 2014, 18(2): R49.
7、 KOUKIASA P, BITZANI M, PAPAIOANNOU V, et al. Resting energy expenditure in critically ill patients with spontaneous intracranial hemorrhage (SICH) [J]. J Parenter Enteral Nutr, 2015, 39(8): 46-49. KOUKIASA P, BITZANI M, PAPAIOANNOU V, et al. Resting energy expenditure in critically ill patients with spontaneous intracranial hemorrhage (SICH) [J]. J Parenter Enteral Nutr, 2015, 39(8): 46-49.
8、 ROUSING M L, HAHN-PEDERSEN M H, ANDREASSEN S, et al. Energy expenditure in critically ill patients estimated by population-based equations, indirect calorimetry and CO2-based indirect calorimetry [J]. Ann Intensive Care, 2016, 6(1): 16. ROUSING M L, HAHN-PEDERSEN M H, ANDREASSEN S, et al. Energy expenditure in critically ill patients estimated by population-based equations, indirect calorimetry and CO2-based indirect calorimetry [J]. Ann Intensive Care, 2016, 6(1): 16.
9、 FERRANNINI E. The theoretical bases of indirect calorimetry: a review [J]. Metabolism, 1988, 37(3): 287-301. FERRANNINI E. The theoretical bases of indirect calorimetry: a review [J]. Metabolism, 1988, 37(3): 287-301.
10、 OSHIMA T, GRAF S, HEIDEGGER C P, et al. Can calculation of energy expenditure based on CO2 measurements replace indirect calorimetry? [J]. Crit Care, 2018, 21(1): 13. OSHIMA T, GRAF S, HEIDEGGER C P, et al. Can calculation of energy expenditure based on CO2 measurements replace indirect calorimetry? [J]. Crit Care, 2018, 21(1): 13.
11、 PICOLO M F, LAGO A F, MENEGUETI M G, et al. Harris-benedict equation and resting energy expenditure estimates in critically ill ventilator patients [J]. Am Crit Care, 2016, 25(1): e21. PICOLO M F, LAGO A F, MENEGUETI M G, et al. Harris-benedict equation and resting energy expenditure estimates in critically ill ventilator patients [J]. Am Crit Care, 2016, 25(1): e21.
12、 FLACK K D, SIDERS W A, JOHNSON L, et al. Cross-validation of resting metabolic rate prediction equations [J]. J Acad Nutr Dietet, 2016, 116(9): 1413-1422. FLACK K D, SIDERS W A, JOHNSON L, et al. Cross-validation of resting metabolic rate prediction equations [J]. J Acad Nutr Dietet, 2016, 116(9): 1413-1422.
13、 MCCLAVE S A, TAYLOR B E, MARTINDALE R G, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) [J]. JPEN, 2016, 40(2): 159-211. MCCLAVE S A, TAYLOR B E, MARTINDALE R G, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) [J]. JPEN, 2016, 40(2): 159-211.
14、 SCHLEIN K M, COULTER S P. Best practices for determining resting energy expenditure in critically ill adults [J]. Nutr Clin Pract, 2014, 29(1): 44-55. SCHLEIN K M, COULTER S P. Best practices for determining resting energy expenditure in critically ill adults [J]. Nutr Clin Pract, 2014, 29(1): 44-55.
15、 YOOJIN L, ORAN K, SOO S C, et al. Use of bioelectrical impedance analysis for the assessment of nutritional status in critically ill patients [J]. Clin Nutr Res, 2016, 4(1): 32-40. YOOJIN L, ORAN K, SOO S C, et al. Use of bioelectrical impedance analysis for the assessment of nutritional status in critically ill patients [J]. Clin Nutr Res, 2016, 4(1): 32-40.
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