Energy metabolism after cardiac surgery utilizing the indirect calorimeter: a new breath by breath technique.
The aim of this study is to clarify the relationship between pyrexia and energy expenditure (EE) after cardiac surgery utilizing the indirect calorimeter. Further the present study tried to determine in changes of energy substrate during mechanical ventilation after cardiac surgery. EE, oxygen consumption (VO2), carbon dioxide production (VCO2), cardiac index (CI), core temperature, and energy substrate were continuously measured in 26 patients after cardiac surgery. The patients were divided into two groups according to the highest core temperature postoperatively; Pyrexia group: > or = 38.5 degrees C, Non-pyrexia group: < 38.5 degrees C. EE after cardiac surgery in non-pyrexias was 1.33 times higher than calculated EE according to the Harris-Benedict equation. Moreover, EE in pyrexias was approximately 1.6 times higher. The mean EE in pyrexias increased to 27.8%/degree C. No significant differences were observed in VO2 or VCO2 between two groups. Time course of CI in pyrexias was different from that in non-pyrexias. Accordingly, energy substrate was not shifted in both groups except fat. This study suggested that the maintenance of core temperature below 38 degrees C after cardiac surgery is important on the aspect of energy metabolism.
Akasu
K
K
Department of Surgery, Kurume University School of Medicine, Japan.
D000328:Adult; D000368:Aged; D001831:Body Temperature; D002151:Calorimetry; D002245:Carbon Dioxide / Q000378:metabolism; D006348:Cardiac Surgical Procedures; D004734:Energy Metabolism; D005260:Female; D005334:Fever / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011446:Prospective Studies
D002245:Carbon Dioxide