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- Original Article Resting Energy Expenditure Measured by Indirect Calorimetry in Major Burn Patients<br> 1) Metabolic Rates<br> 2) The Factors Influencing “Resting Energy Expenditure”
- Yong Suk Cho, M.D., Haejun Yim, M.D., Dohern Kim, M.D., Jun Hur, M.D., Jong Hyun Kim, M.D., Wook Chun, M.D.
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중증화상 환자에서 간접휴식대사량 측정기를 이용한 휴식대사량 측정 - 조용석ㆍ임해준ㆍ김도헌ㆍ허 준ㆍ김종현ㆍ전 욱
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Surgical Metabolism and Nutrition 2010;1(1):36-41.
Published online: December 30, 2010
Department of Burn Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
한림대학교 의과대학 한강성심병원 화상센터
한림대학교 의과대학 한강성심병원 화상센터
Received: 17 June 2010 • Revised: 14 December 1901 • Accepted: 24 June 2010
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Abstract
Purpose: The purpose of this study was to analyze metabolic rates and factors influencing resting energy expenditure (REE) by indirect calorimetry (IC) in major burn patients.
Materials and Methods: One-hundred and ninety-nine patients who were admitted to Hangang Sacred Heart Hospital with burns on 20% of their total body surface area (TBSA) were enrolled, with 403 measurements of resting energy expenditure (REE) from January 2004 to December 2008. REE was measured by IC. Calculated metabolic rates were compared to five predictive equations. Also, gender, age, burn size, inhalation injury, and ventilation therapy were included in the factors influencing the REE of major burn patients.
Results: The measurement of REE was 1.26 times basal energy expenditure (BEE) as calculated by the Harris-Benedict equation. Prediction by the Curreri formula was 2.19 times greater than measured REE, suggesting the formula’s significant overestimation of energy expenditure. Comparing measured REE with Xie, Zawacki, and Milner’s formula showed that the formula was similar to measured REE (Pearson correlation 0.399). Measured REE and REE/BMR were significantly higher in males (P<0.05), and measured REE and REE/BMI showed significant differences between age groups (P<0.01). Measured REE and REE/BMI also showed significant differences between burn size groups (P<0.01). In patients with inhalation injury, measured REE, REE/BMR, and REE/BMI were significantly higher than in patients without inhalation injury (P<0.01). For patients needing aventilator, measured REE, REE/BMR, and REE/BMI were significantly higher than for those not requiring ventilation therapy (P<0.01).
Conclusion: Indirect calorimetry is useful in detecting variations in energy expenditure among individuals as well as for detecting changes in metabolism. Because the REE of massive burn patients is affected by various factors, these should be considered when determining nutritional support for massive burn patients. (SMN 2010;1:36-41)
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