Energy expenditure in the acute renal failure patient mechanically ventilated.
Twenty mechanically ventilated patients with acute renal failure were studied on 31 occasions to determine their energy expenditure (EE) during a 2 h period before a hemodialysis. Oxygen consumption and CO2 elimination were measured continuously with a mass spectrometer system. EE (1660 +/- 48 kcal day-1) was close to the total caloric intake (1682 +/- 83 kcal day-1) and represented 1.19 +/- 0.03 times the predicted resting energy expenditure (PREE) with large inter-individual variations (0.7-1.7 PREE). EE/PREE was higher when sepsis was present (1.31 +/- 0.03 versus 1.14 +/- 0.02; p less than 0.05). Glucose oxidation rate (4.35 mg kg-1 min-1) exceeded glucose intake (2.6 mg kg-1 min-1). Respiratory quotient was 1.02 +/- 0.01. Nitrogen loss was 17.3 +/- 1.7 g day-1 and nitrogen balance -11.9 +/- 1.9 g day-1. In conclusion, EE values were scattered but never exceeded 1.7 times the PREE. Sepsis increased EE. With a nutritional support covering EE, nitrogen balance remained markedly negative and a preferential utilisation of glucose and lipogenesis occurred.
Bouffard
Y
Y
Département d'Anesthésie-Réanimation, Hôpital Edouard Herriot, Lyon, France.
Viale
J P
JP
Annat
G
G
Delafosse
B
B
Guillaume
C
C
Motin
J
J
D058186:Acute Kidney Injury / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D002149:Energy Intake; D004734:Energy Metabolism; D006801:Humans; D007239:Infections / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D013058:Mass Spectrometry; D008875:Middle Aged; D012121:Respiration, Artificial