Resting energy expenditure during mechanical ventilation and its relationship with the type of lesion.
BACKGROUND
Resting energy expenditure (REE) of critically ill patients is usually calculated according to basal energy expenditure obtained from Harris-Benedict equations traditionally corrected by different stress factors, resulting in a variable accuracy for the individual patient. The objective of this study was to investigate whether or not the type of lesion affects the metabolism level of critically ill patients treated with mechanical ventilation. We performed a retrospective study measuring the REE of critically ill patients with 3 different types of lesions (trauma, medical, surgical) who were treated with mechanical ventilation and sedation. Each lesion group of patients was matched with another group, differing in the type of lesion, according to gender, age, and weight.


METHODS
Eighty-seven from a database of 175 critically ill patients undergoing indirect calorimetry were necessary for matching. Twenty matched pairs of patients for each of the following different type of lesion were obtained: medical vs surgical, medical vs trauma, and surgical vs trauma.


RESULTS
The mean REE difference was 52 kcal/d (95% confidence interval [CI] of -136 -241 kcal/d) for the medical vs surgical group, 5 kcal/d (95% CI -236 -247 kcal/d) for the medical vs trauma group and 43 kcal/d (95% CI of -132-219 kcal/d) for the surgical vs trauma group. No statistically significant differences between groups were found in the measured REE. We did not find statistically significant differences in the measured REE of patients with and without infection.


CONCLUSIONS
Critically ill patients with different types of lesion treated with mechanical ventilation have similar measured REE.
Raurich
Joan Maria
JM
Intensive Care Unit, Son Dureta Hospital, Palma de Mallorca, Spain. jmraurich@hsd.es
Ibáñez
Jordi
J
Marsé
Pere
P
Riera
María
M
Homar
Xavier
X
D001481:Basal Metabolism / Q000502:physiology*; D002153:Calorimetry, Indirect; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D010101:Oxygen Consumption; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014947:Wounds and Injuries / Q000378:metabolism*