Annals of Clinical Nutrition and Metabolism

Original Article

Determination of the Stress Factor Calculated from the Changes in the Measured Resting Energy Expenditure with Indirect Calorimetry in Patients Undergoing Pancreaticoduodenectomy: Seon Hyeong Kim, Baik Hwan Cho, Sook Bae Kim, Mi Jin Jeong, Hee Chul Yu; J Clin Nutr 2017;9(2):62-67. Published online December 31, 2017; DOI: https://doi.org/10.15747/jcn.2017.9.2.62

Abstract PDF: Purpose
To predict the energy expenditure using the stress factor representing the ratio of the metabolic variation between pre-operation and post-operation in a pancreaticoduodenectomy (PD).
Methods
This was a prospective study conducted on 17 patients (11 males and 6 females) who underwent PD at Chonbuk National University Hospital between March 2010 and October 2011. The rest energy expenditure was measured by indirect calorimetry 1 day before and 3 days after surgery. The height, weight, and fat free mass were also measured 1 day before surgery.
Results
The mean measured rest energy expenditure 1 day before PD (mREE^pre) and 3 days after PD (mREE^post) were significantly different (16.8±2.6 vs. 18.8±3.5 kcal/kg/d, P=0.0076). The stress factor, representing the ratio of the metabolic changes between pre- and post-PD, was 1.12±0.17. The recommended energy requirement for PD patients is estimated to be 23∼24 kcal/ideal body weight/d [determined from the measured preoperative rest energy expenditure (16.8±2.6 kcal/kg/d)×activity factor (1.2∼1.3)×stress factor (1.12)].
Conclusion
PD patients maintained a hypermetabolic status and the applicable stress factor was 1.12.

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