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A Comparison Between Measured and Predicted Resting Energy Expenditure of Pancreaticoduodenectomy Patients
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Ann Clin Nutr Metab : Annals of Clinical Nutrition and Metabolism

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Original Article A Comparison Between Measured and Predicted Resting Energy Expenditure of Pancreaticoduodenectomy Patients
Seon Hyeong Kim2,4, Hee Chul Yu, M.D.1,2, Baik Hwan Cho, M.D.1,2, Soo Wan Chae, M.D.3, Mi Jin Jeong2, Yeong Ran Choi2, Haeng Sun Kim, Ph.D.2, Ju Sin Kim, Ph.D.2, Sook Bae Kim, Ph.D.4

췌십이장절제술 환자의 휴식대사량 측정방법 비교 분석
김선형2,4ㆍ유희철1,2ㆍ조백환1,2ㆍ채수완3ㆍ정미진2ㆍ최영란2ㆍ김행순2ㆍ김주신2ㆍ김숙배4
Journal of Clinical Nutrition 2013;5(1):24-30.
DOI: https://doi.org/10.15747/jcn.2013.5.1.24
Published online: April 1, 2013
1Department of Surgery, Chonbuk National University Medical School,
2Nutrition Support Team,
3Biomedical Research Institute, Chonbuk National University Hospital,
4Department of Food Science and Human Nutrition, Chonbuk National University, Jeonju, Korea

1전북대학교 의학전문대학원 외과학교실,
2전북대학교병원 영양집중지원팀,
3전북대학교병원 의생명연구원,
4전북대학교 생활과학대학 식품영양학과
Received: 14 December 1901   • Revised: 14 December 1901   • Accepted: 14 December 1901
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Purpose
An accurate determination of energy expenditure is needed to prevent postoperative complications and provide effective medical care for surgical patients. The aim of this study was to compare measured resting energy expenditure (REE) in patients undergoing pancreaticoduodenectomy (PD) using an indirect calorimetry (IC) with the help of five predictive equations. Methods: The subjects chosen for the study were 18 patients (12 males, 6 females) who underwent PD at Chonbuk National University Hospital between March 2010 and October 2011. REE was measured by IC (ICREE) and calculated with the following five predictive equations - (eqREE)-Harris-Benedict (HB), Mifflin St. Jeor (MI), American College of Chest Physician (AC), Ireton- Jones (IJ) and Cunningham (CU) equation - on postoperative day 3. Results: The mean measured REE by IC was 1,117.9 ±180.2, whereas the mean predicted REE by HB, MI, AC, IJ and CU equations were 1,241.3±156.1, 1,226±153.0, 1,401.7±188.0, 1,355.1±342.7, and 1,324.8±188.7 kcal/ day, respectively. The mean predicted REE by HB, MI, AC, IJ, and CU were found to be significantly different from the measured ICREE. The intraclass correlation coefficient (ICC), which describes the degree of agreement with the ICREE, was significantly highest in CUeqREE (r= 0.679). The rate of accuracy of HBeqREE, MIeqREE, ACeqREE, IJeqREE, and CUeqREE for ICREE was 27.8%, 50.0%, 27.8%, 22.2%, and 23.5%, respectively, in individual subjects. Conclusion: The intraclass correlation coefficient (r= 0.124∼0.679) and accuracy rate (22.2∼50.0%) determined from the results of REE measured by IC and that calculated by five predictive equations were low in overall. The low accuracy rate of energy expenditure by equations, which apply uniform indicators, can be explained by ongoing metabolic changes of the patient. Thus, the use of IC is recommended to assess energy requirements in PD; when this method is not practical in clinical settings, nutrition intervention is needed through regular monitoring because of the low accuracy rate of the predictive methods and ICREE that can cause inappropriate energy management, leading to metabolic disorders. (JKSPEN 2013;5(1):24-30)


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