Comparison of IC and HB methods on energy consumption and its influencing factors in patients with multiple trauma / 中华急诊医学杂志

ABSTRACT

objective:To evaluate the difference 24h energy expenditure in patients with multiple trauma mechanical ventilation predicted by indirect calorimetry (IC) and HB formula. To explore the correlation between energy expenditure and Injury Severity Scoring (ISS) in patients with multiple trauma, and to predict the stress coefficient to improve the accuracy of HB prediction.Methods:A total of 152 patients with multiple trauma receiving mechanical ventilation were included in the ICU of the General Hospital of Ningxia Medical University during December 1st, 2016 to August 31st, 2018. As a research object, The IC method and the HB method were used to simultaneously measure the patient's 24h energy expenditure, and the difference between the two measurement methods was compared. The 24h energy consumption measured by the IC method was used as the "gold standard", and the 24h body weight energy expenditure per kilogram was calculated; Grouped according to the ISS score, compared 24h energy consumption with 24h body weight energy expenditure per kilogram. The Bland-Altman method was used to test the consistency of the two measurements. The two groups were compared using t test, the correlation was analyzed by pearson correlation, and the regression equation was linearly calculated by linear regression.Results:There was a significant bias between the IC method and the HB method in measuring the 24h energy expenditure of patients with multiple trauma, with an average bias of 394.0± 54.0Kcal/d. The 24h energy consumption and 24h body weight energy expenditure per kilogram in the severe injured group were significantly higher than those in the moderate injury group ( P<0.05). The stress coefficient was calculated, The stress coefficient of the HB method associated with the ISS using the one-way regression was Y=0.770+0.018×ISS. Conclusion:The HB method significantly underestimates the 24h energy expenditure of patients with multiple trauma . In order to improve the accuracy of the HB method to predict the 24h energy consumption of patients with multiple injuries, The HB method can be corrected using the stress coefficient associated with the ISS score, Y = (0.770 + 0.018 × ISS) × HB method.