Factors Affecting Resting Energy Consumption In Patients With Invasive Mechanical Ventilation

Objective:To measure the daily resting energy expenditure(MREE)of patients with invasive mechanical ventilation in one week by indirect calorimetry(IC),and use the H-B formula to calculate the predicted daily resting energy expenditure(REEp)of the patients.Compared the characteristics of patients with MREE during the early stage of invasive mechanical ventilation,and explored the influence of different factors on the MREE of patients with invasive mechanical ventilation,and studied the weight,height,respiratory quotient,temperature,systolic blood pressure,heart rate,and related laboratory tests relevance to MREE.Methods:105 patients with invasive mechanical ventilation who were admitted to the comprehensive ICU of the Second Affiliated Hospital of Soochow University from July 2018 to June 2019 and met the study selection criteria were collected.Basic clinical information was collected and measured by IC method.Measure the patients 'daily resting energy expenditure(MREE)during one week of invasive mechanical ventilation,and the patients' daily resting energy expenditure prediction(REEp)was calculated using the H-B formula,compared the two results and collected Heart rate,temperature,blood pressure and related laboratory tests at the same.According to the main causes of the patients admitted to the ICU,the patients were divided into the medical group and the surgical group.The characteristics of the early resting energy expenditure of invasive mechanical ventilation in the two groups were analyzed,and the differences in the daily MREE between the two groups were compared.According to the 2016 World Health Organization's age segmentation,patients were divided into young group,middle-aged group,and elderly group.The characteristics of resting energy expenditure in early stage of invasive mechanical ventilation were analyzed in the three groups,and differences of daily MREE between different age groups were compared.Analyze the characteristics of early resting energy expenditure of septic patients in invasive mechanical ventilation patients,and divide them into septic shock group and septic non-shock group according to the presence if shock in septic patients.Analyze the characteristics of early resting energy expenditure in two groups of patients with invasive mechanical ventilation,and compare the differences in the daily MREE between the two groups of patients.The patients were divided into two groups based on whether the APACHE ? score was greater than 15 points.The characteristics of resting energy expenditure in early stage of invasive mechanical ventilation were analyzed in the two groups,and the differences in daily MREE between the two groups were compared.The correlation between MREE and APACHE ? score was analyzed.Multivariate analysis was used to analyze the affecting factors of resting energy expenditure in patients with invasive mechanical ventilationResults:Within one week of invasive mechanical ventilation,the daily MREE of patients was significantly higher than the REEp,and the difference was statistically significant(P<0.05).The daily MREE of patients in the invasive mechanical ventilation surgery group was higher than that in the medical group on the first to fourth day of treatment,and there was a statistically significant difference between the two groups(P<0.05).The daily MREE within one week of invasive mechanical ventilation in the young group,middle-aged group,and elderly group patients was the young group>middle-aged group>the elderly group had statistically significant differences(P<0.05),and MREE was significantly negatively related to age(r=-0.537).On day 1-6 of invasive mechanical ventilation in patients with sepsis,the daily MREE in the non-shock group was higher than that in the shock group,and the difference was statistically significant(P<0.05).Within a week of invasive mechanical ventilation for patients with APACHE ?<15 and APACHE??15,there was no significant difference in the daily average MREE between the two groups(P>0.05),and there was a weak correlation between MREE and APACHE ?(r=-0.221).Correlation between MREE,weight,respiratory quotient,temperature,and CRP.Conclusion:In the early stage of invasive mechanical ventilation,the patients are generally in a high metabolic state;surgical patients have higher MREE than medical patients;age and MREE are significantly negatively correlated;among patients with sepsis,MREE in shock patients is significantly lower than non-shock patients;Correlation with APACHE ? score was low;weight,respiratory quotient,body temperature,CRP and MREE were correlated.