Energy requirement assessed by doubly-labeled water method in patients with advanced amyotrophic lateral sclerosis managed by tracheotomy positive pressure ventilation.
This study aimed to clarify the energy requirement in patients with amyotrophic lateral sclerosis (ALS) undergoing tracheostomy positive pressure ventilation with tracheostomy. Total energy expenditure (TEE) was measured in 10 hospitalized bedridden ALS patients using the doubly-labeled water (DLW) method. The mean TEE/day and TEE/fat- free mass estimated by DLW method were 934 ± 201 kcal/day and 34.8 ± 5.5 kcal/kg/day, respectively. The mean TEE/resting metabolic rate (RMR) was 0.85 when RMR was estimated by the Harris-Benedict equation, 0.91 by Dietary Reference Intake (DRI), and 0.97 by Ganpule's equation using fat-free mass (FFM). The ratios of TEE to measured RMR were 1.05, 1.15 and 1.23 in three patients. In conclusion, multiplying measured RMR by 1.1 to 1.2 is considered to be appropriate to estimate energy need. However, because it is difficult to measure RMR directly in a clinical setting, an appropriate equation for estimating RMR for ALS patient should be developed.
Department of Neurology, National Hospital Organization Takamatsu Medical Center, Takamatsu, Japan. ichihara@takamatu.hosp.go.jp
Noriko
N
Ichihara
Kazuyoshi
K
Namba
Kazuko
K
Ishikawa-Takata
Kazunori
K
Sekine
Mitsunori
M
Takase
Yuko
Y
Kamada
Seigo
S
Fujii
D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000378:metabolism / Q000628:therapy*; D003903:Deuterium; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000379:methods*; D012146:Rest / Q000502:physiology; D014140:Tracheotomy
D003903:Deuterium