title: Energy expenditure in ischemic stroke patients treated with moderate hypothermia.
abstract: OBJECTIVE
  To determine total energy expenditure (TEE) in patients with acute ischemic stroke in the territory of the middle cerebral artery (MCA), treated with moderate hypothermia (33 degrees C).
  
  
  METHODS
  Prospective study in a neurological ICU.
  
  
  METHODS
  Ten consecutive patients with severe MCA infarction undergoing moderate hypothermia.
  
  
  RESULTS
  Indirect calorimetry was performed continuously over the first 6 days after admission. Mean daily TEE decreased significantly from 1549 before initiation of hypothermia to 1099, 1129, and 1157 on the first, second, and third days of hypothermia, respectively and returned to baseline values after hypothermia was terminated. The ratio of TEE to predicted basal energy expenditure declined from 1.01 before induction of hypothermia to an average of 0.74 during steady state of hypothermia and increased to 1.16 after rewarming.
  
  
  CONCLUSIONS
  We found a significant fall in TEE in sedated, curarized, and ventilated ischemic stroke patients during moderate hypothermia. Indirect calorimetry appears to be a useful tool for measuring energy expenditure in these patients, as predicted basal energy expenditure overestimates the caloric requirements during hypothermia.
authors.affiliation: Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. juergen_bardutzky@med.uni-heidelberg.de
authors.forename: Juergen
authors.initials: J
authors.lastname: Bardutzky
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Georgiadis
authors.forename: Rainer
authors.initials: R
authors.lastname: Kollmar
authors.forename: Stefan
authors.initials: S
authors.lastname: Schwab
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001481:Basal Metabolism; D015982:Bias; D002545:Brain Ischemia / Q000378:metabolism* / Q000628:therapy*; D002153:Calorimetry, Indirect / Q000379:methods* / Q000592:standards; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D010101:Oxygen Consumption; D010289:Parenteral Nutrition, Total / Q000379:methods; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods; D012709:Serum Albumin / Q000378:metabolism; D018709:Statistics, Nonparametric; D020521:Stroke / Q000378:metabolism* / Q000628:therapy*; D013997:Time Factors
chemical_list: D012709:Serum Albumin