A comparative study of the respiratory indirect calorimetry and HB coefficient method for the guidance of the target energy in patients with sepsis / 中华临床营养杂志

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 Jan-uary 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 "&Delta;". Values of &Delta; were compared between the two goups. Results With nutritional support for 3 days, &Delta;albumin,&Delta; prealbumin, &Delta;the total T lymphocytes, &Delta;assist/induction of T cells and &Delta;IgG were higher in the respiratory indirect calorimetry group than in the HB coefficient group ( P<0. 05) . With nutritional support for 7 days, &Delta;albumin, &Delta;T lymphocytes, &Delta;IgM were higher in the respiratory indirect calorimetry group than in the HB coefficient group ( P<0. 05) . With nutritional support for 14 days, &Delta;transferrin, &Delta;suppression/cyto-toxic T cells, &Delta;IgG, &Delta;IgA, &Delta;C3 and&Delta;C4 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 in-direct calorimetry in patients with sepsis is more effective on nutritional and immune related indexes improve-ment have different degrees of improvement, thus respiratory indirect calorimetry is more suitable to guide the target energy of sepsis patients.