Study About Measurement Of Resting Energy Expenditure On Mechanically Ventilated Critically Illness By Indirect Calorimetry

Objective: Determine the resting energy expenditure on mechanical ventilation incritically ill patients by indirect calorimetry，then assess their level of REE. On this basis,evaluate the nutritional support up to goal in critical patients.Discussion on influencing factors ofenergy consumption in critically ill patients and relevance of relevant indicators, to provide a basis formonitoring and clinical nutrition intervention.Methods: Resting energy expenditure ofmechanically ventilated patients in ICU ward of Autonomous Region People’s Hospitalwere determined by U.S. Med Graphic Company CCM/D Energy metabolism test systemFrom December2010to February2011, Patient related information and bio-indicators wererecorded. Results were compared with PEE Calculated by the harris-benedict formula and alsocompared with actual nutrition supply of patients to evaluate the nutritional support up to goal.Analysis of variance and Multiple regression analysis were used to analysis The relationshipbetween General information of patients, Biochemical markers and Resting energy expenditure.Results: There were significant differences between measured value of REE andpredictive value of the formula HB(P<0.05). However, not all patients are in a state ofhigh metabolic, The results showed that51%of patients in a high metabolic state,29%ofpatients in the metabolism of the normal state, about20%of patients in a low metabolicstate. The results also showed the differences of the RQ values between differentmetabolic states were not significantly. Show that there is relation between Heart rate,blood oxygen pressure, tribes, creatinine and REE. It also showed that there is no relationbetween the APACHE II,TP,ALB, Body temperature and REE.In the group of up togoal,87.5%of patients in a low metabolic state or in a normal state. In the group of not up to goal,54.3%of patients in a low metabolic state or in a normal state54.3%,the difference was statisticallysignificant. The Percentage of EN and PN&EN in group of up to goal was significantly higher than thatin group of not up to goal(71.8%VS43.5%).Conclusion: resting energy expenditure value ofCritically ill patients have greater individual differences. Clinically, we should supply energyin accordance with the actual measured values of energy consumption measured by Indirect calorimetry. Heart rate，family，and other factors have an impact on value of REE. t is easyto achieve nutrition goal when patients in a low metabolic state or in a normal state. The use of enternalnutrition is helpful to enhance the rate of nutrition up to goal, the enteranl nutrition should be used ifthe situation allowed.