Resting energy expenditure in patients with pancreatitis.
OBJECTIVE
To assess the resting energy expenditure of hospitalized patients with pancreatitis.


METHODS
Prospective, case-referent study.


METHODS
Nutrition support service in a university tertiary care hospital.


METHODS
Patients referred to the Nutrition Support Service with the diagnosis of pancreatitis. Excluded from study entry included those with cancer, obesity (greater than 150% ideal body weight), those measured within 3 postoperative days, or patients requiring ventilator support with an FIO2 of greater than 0.5. Forty-eight patients with either acute pancreatitis (n = 13), chronic pancreatitis (n = 24), acute pancreatitis with sepsis (n = 7), or chronic pancreatitis with sepsis (n = 7) were studied. The two septic groups were combined into a single pancreatitis-with-sepsis group, since no significant differences among measured variables were observed between individual septic groups.


METHODS
None.


RESULTS
Resting energy expenditure was measured by indirect calorimetry and compared with the predicted energy expenditure, as determined by the Harris-Benedict equations. Resting energy expenditure (percent of predicted energy expenditure) was significantly (p less than .02) greater for patients with pancreatitis complicated by sepsis (120 +/- 11%) compared with the nonseptic chronic pancreatitis group (105 +/- 14%). Resting energy expenditure for the nonseptic acute pancreatitis patients (112 +/- 17%) was not significantly different from the other groups. The septic pancreatitis group had the largest percentage (82%) of hypermetabolic (resting energy expenditure greater than 110% of predicted energy expenditure) patients, whereas 61% and 33% of the acute and chronic pancreatitis groups were hypermetabolic, respectively (p less than .02).


CONCLUSIONS
Resting energy expenditure is variable in patients with pancreatitis (77% to 139% of predicted energy expenditure). The Harris-Benedict equations are an unreliable estimate of caloric expenditure. Septic complications are associated with hypermetabolism and may be the most important factor influencing resting energy expenditure in pancreatitis patients.
Dickerson
R N
RN
Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy and Science, PA 19104-4495.
Vehe
K L
KL
Mullen
J L
JL
Feurer
I D
ID
D000208:Acute Disease; D000328:Adult; D001831:Body Temperature; D002153:Calorimetry, Indirect; D002908:Chronic Disease; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000378:metabolism*; D011446:Prospective Studies; D018805:Sepsis / Q000150:complications / Q000378:metabolism