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 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.
3.Evaluation of Hazardous Chemicals with Material Safety Data Sheet and By-products of a Photoresist Used in the Semiconductor-Manufacturing Industry
Miyeon JANG ; Chungsik YOON ; Jihoon PARK ; Ohhun KWON
Safety and Health at Work 2019;10(1):114-121
BACKGROUND: The photolithography process in the semiconductor industry uses various chemicals with little information on their constitution. This study aimed to identify the chemical constituents of photoresist (PR) products and their by-products and to compare these constituents with material safety data sheets (MSDSs) and analytical results. METHODS: A total of 51 PRs with 48 MSDSs were collected. Analysis consisted of two parts: First, the constituents of the chemical products were identified and analyzed using MSDS data; second, for verification of the by-products of PR, volatile organic compounds were analyzed. The chemical constituents were categorized according to hazards. RESULTS: Forty-five of 48 products contained trade secrets in amounts ranging from 1 to 65%. A total of 238 ingredients with multiple counting (35 ingredients without multiple counting) were identified in the MSDS data, and 48.7% of ingredients were labeled as trade secrets under the Korea Occupational Safety and Health Act. The concordance rate between the MSDS data and the analytical result was 41.7%. The by-product analysis identified 129 chemicals classified according to Chemical Abstracts Service No., with 17 chemicals that are carcinogenic, mutagenic, and reprotoxic substances. Formaldehyde was found to be released from 12 of 21 products that use novolak resin. CONCLUSION: We confirmed that several PRs contain carcinogens, and some were not specified in the toxicological information in the MSDS. Hazardous chemicals, including benzene and formaldehyde, are released from PRs products as by-products. Therefore, it is necessary to establish a systematic management system for chemical compounds and the working environment.
Benzene
;
Carcinogens
;
Constitution and Bylaws
;
Formaldehyde
;
Hazardous Substances
;
Korea
;
Material Safety Data Sheets
;
Occupational Health
;
Semiconductors
;
Volatile Organic Compounds
4.A Case of Trichosoporon insectorum Peritonitis in a Continous Ambulatory Peritoneal Dialysis Patient.
Miyeon KIM ; Woo Seong JEONG ; Hyun Woo KIM ; Young Ree KIM ; Keun Hwa LEE ; Eun Hee JANG
Korean Journal of Nephrology 2011;30(3):346-350
CAPD peritonitis caused by Trichosporon species is uncommon. We report a case of peritonitis due to T. insectorum in a 38-year-old man who had undergone CAPD for about 1 year. He presented with abdominal pain. The clinical signs and analysis of peritoneal fluid were consistent with CAPD peritonitis. Patient deteriorated despite empirical antibiotics therapy. Repeated peritoneal culture revealed Trichosporon species. The peritonitis was treated with CAPD catheter removal and administering amphotericin B and fluconazole. We isolated T. insectorum by DNA sequencing method. We hereby report the first case of T. insectorum CAPD peritonitis.
Abdominal Pain
;
Adult
;
Amphotericin B
;
Anti-Bacterial Agents
;
Ascitic Fluid
;
Catheters
;
Fluconazole
;
Humans
;
Peritoneal Dialysis
;
Peritoneal Dialysis, Continuous Ambulatory
;
Peritonitis
;
Sequence Analysis, DNA
;
Trichosporon