1.Comparison of Energy Requirements of Patients with Brain Injury of the Intensive Care Unit: Indirect Calorimetry vs. Predictive Equations
EunJoo BAE ; SeongSuk KANG ; MiYeon KIM ; JinYoung JANG ; HyunJung LIM ; TaeGon KIM
Journal of Clinical Nutrition 2020;12(2):41-47
Purpose:
The metabolic activity and demand usually increase in seriously ill patients, especially in patients with a brain injury (BI). These nutritional demands have been traditionally satisfied using predictive equations (PEs). Recently, indirect calorimetry (IC) has been used widely because it is more accurate than other methods. This study measured the energy expenditures (EE) using IC (GE, CARESCAPE B650, Helsinki, Finland) and calculated the PEs simultaneously in patients with BI.
Methods:
This study was conducted on 55 patients with a BI for three years (2017.7∼2020.8), who were mechanically ventilated within a hospital for ≤seven days. The EE values using IC were measured once in each patient, and the EE values using PE were calculated using 5 PEs (ESPEN, Harris-Benedict, HB; Frankenfield, FK; Penn state, PS; and Faisy) at the same time.The 55 patients were divided into two groups, acute group (39 patients; ≤3 hospital days group, AG) and subacute group (16 patients; >3 hospital days group, SG) according to the time, and the values were obtained.
Results:
There were no differences in the patient’s characteristics between the two groups, including age, gender, severity of the condition (Simplified Acute Physiology Score II), and anthropometric parameters. In AG, the energy expenditure values using PEs were significantly lower than those using IC in the three PEs (IC 1,712.0±476 kcal, ESPEN 1,558.6±324 kcal, P=0.038, HB 1,582.4±273 kcal, P=0.037, PS 1,530.8±340 kcal, P=0.005). In SG, the EE value using PEs did not differ significantly from that using IC.
Conclusion
An accurate assessment of EE is critical for seriously ill patients. These results showed that the previously well-known PEs might not be correct, particularly in acute patients with BI. Therefore, it is recommended that the EE values be obtained using IC, at least in acute patients with BI.
2.Comparison of Anthropometric Measurements, Dietary Quality and Blood Lipid Levels in Ssireum Players, Regular Moderate and Intermittent Light Exercisers.
Eunjoo BAE ; Hyeok LEE ; Myungchun LEE ; Ryowon CHOUE
The Korean Journal of Nutrition 2006;39(7):661-673
Ssireum, the traditional Korean sport, is very popular at both amateur and professional levels. Ssireum players are prone to be obese which related to the chronic disease in their later life. The purpose of the study was to compare the anthropometric measurements, quality of diet, and blood parameters of Ssireum players with those of subjects who were matched body mass index, gender and age. Participants in the 3 groups, Ssireum players (SP, n = 15), regular moderate exerciser (RME, n = 15, > 3 times /wk, > 20 min/time) and intermittent light exerciser (ILE, n = 14) groups. Anthropometric measurements included height, weight, fat mass (by Dual energy X-ray absorptiometry), lean body mass, triceps and thigh skin-fold thickness, mid-arm, waist, hip and thigh circumference. Dietary assessments were accomplished using 3-days food records, diet quality index (DQI), dietary variety score (DVS). Blood levels of lipids, leptin and insulin were analyzed. As a results lean body mass and mid-arm circumference were significantly higher in Ssireum players than those of other groups (p < 0.01). Total body fat, trunk fat, abdominal skin fold thickness and waist-hip ratio were significantly lower in SP group than those of other groups (p < 0.01). DVS were higher however, dietary quality was low in Ssireum players than in other groups. There were no differences among the 3 groups in regard to blood total cholesterol, LDL-cholesterol and glucose levels however, leptin level was low in Ssireum players. These results indicate that Ssireum players had significantly higher lean body mess and lower body fat when these were compared with regular moderate exerciser and intermittent light exerciser. Blood leptin levels of Ssireum players were low but blood lipid profiles were not significantly different.
Abdominal Fat
;
Adipose Tissue
;
Anthropometry
;
Body Mass Index
;
Cholesterol
;
Chronic Disease
;
Diet
;
Diet Records
;
Glucose
;
Hip
;
Insulin
;
Leptin
;
Skin
;
Sports
;
Thigh
;
Waist-Hip Ratio
3.Comparison of Energy Requirements of Patients with Brain Injury of the Intensive Care Unit: Indirect Calorimetry vs. Predictive Equations
EunJoo BAE ; SeongSuk KANG ; MiYeon KIM ; JinYoung JANG ; HyunJung LIM ; TaeGon KIM
Journal of Clinical Nutrition 2020;12(2):41-47
Purpose:
The metabolic activity and demand usually increase in seriously ill patients, especially in patients with a brain injury (BI). These nutritional demands have been traditionally satisfied using predictive equations (PEs). Recently, indirect calorimetry (IC) has been used widely because it is more accurate than other methods. This study measured the energy expenditures (EE) using IC (GE, CARESCAPE B650, Helsinki, Finland) and calculated the PEs simultaneously in patients with BI.
Methods:
This study was conducted on 55 patients with a BI for three years (2017.7∼2020.8), who were mechanically ventilated within a hospital for ≤seven days. The EE values using IC were measured once in each patient, and the EE values using PE were calculated using 5 PEs (ESPEN, Harris-Benedict, HB; Frankenfield, FK; Penn state, PS; and Faisy) at the same time.The 55 patients were divided into two groups, acute group (39 patients; ≤3 hospital days group, AG) and subacute group (16 patients; >3 hospital days group, SG) according to the time, and the values were obtained.
Results:
There were no differences in the patient’s characteristics between the two groups, including age, gender, severity of the condition (Simplified Acute Physiology Score II), and anthropometric parameters. In AG, the energy expenditure values using PEs were significantly lower than those using IC in the three PEs (IC 1,712.0±476 kcal, ESPEN 1,558.6±324 kcal, P=0.038, HB 1,582.4±273 kcal, P=0.037, PS 1,530.8±340 kcal, P=0.005). In SG, the EE value using PEs did not differ significantly from that using IC.
Conclusion
An accurate assessment of EE is critical for seriously ill patients. These results showed that the previously well-known PEs might not be correct, particularly in acute patients with BI. Therefore, it is recommended that the EE values be obtained using IC, at least in acute patients with BI.
4.Effects of a low-FODMAP enteral formula on diarrhea on patients in the intensive care unit
Eunjoo BAE ; Jiyoon KIM ; Jinyoung JANG ; Junghyun KIM ; Suyeon KIM ; Youngeun CHANG ; MI YEON KIM ; Mira JEON ; Seongsuk KANG ; Jung Keun LEE ; Tae Gon KIM
Nutrition Research and Practice 2021;15(6):703-714
BACKGROUND/OBJECTIVES:
A dietary restriction on the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has been reported to be effective in the treatment of gastrointestinal (GI) tract complications. Enteral nutrition (EN) is widely used for patients who cannot obtain their nutritional requirements orally, but many studies have reported EN complications, especially diarrhea, in up to 50% of patients.
SUBJECTS/METHODS:
We performed a single-center, non-randomized, controlled trial to determine the effects of a low-FODMAP enteral formula on GI complications in patients in intensive care units (ICUs). Patients in the ICU who needed EN (n = 66) were alternately assigned to the low-FODMAP group (n = 33) or the high-FODMAP group (n = 33).
RESULTS:
Anthropometric and biochemical parameters were measured, and stool assessment was performed using King's Stool Chart. We excluded patients who received laxatives, GI motility agents, proton pump inhibitors, antifungal agents, and antibiotics other than β-lactams. There were no differences in GI symptoms during 7 days of intervention, including bowel sound, abdominal distension, and vomiting between the 2 groups. However, diarrhea was more frequent in the high-FODMAP group (7/33 patients) than the lowFODMAP group (1/33 patients) (P = 0.044).
CONCLUSIONS
Our results suggest that a low-FODMAP enteral formula may be a practical therapeutic approach for patients who exhibit enteral formula complications. Our study warrants further randomized clinical trials and multicenter trials.