Effects of nutritional therapy based on indirect calorimetry in patients with extremely severe burns during hypermetabolic stage
10.3760/cma.j.cn501225-20240320-00103
- VernacularTitle:特重度烧伤患者代谢高涨期进行基于间接测热法的营养治疗的效果
- Author:
Bin JIANG
1
;
Yong DU
1
;
Yilan XIA
1
;
Huaqing CHEN
1
;
Fuchang LU
1
Author Information
1. 浙江大学医学院附属第二医院护理部，杭州 310000
- Publication Type:Journal Article
- Keywords:
Burns;
Calorimetry, indirect;
Energy metabolism;
Nutritional support;
Prognosis
- From:
Chinese Journal of Burns
2025;41(1):94-100
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of nutritional therapy based on indirect calorimetry in patients with extremely severe burns during hypermetabolic stage.Methods:This study was a retrospective cohort study. From March 25, 2022 to March 30, 2024, 20 extremely severe burn patients who met the inclusion criteria were admitted to the Department of Burn and Wound Repair of the Second Affiliated Hospital of Zhejiang University School of Medicine. There were 15 males and 5 females, aged (46±12) years. The patients were divided into death group (6 cases) and survival group (14 cases) according to their treatment outcomes. At the 3 rd, 7 th, 14 th, and 21 st d after injury, the resting energy expenditure (REE) of patients in the two groups was measured by indirect calorimetry once a day, and the nutritional treatment scheme was formulated according to the results of REE. The REE value, levels of albumin and interleukin-6 (IL-6), actual energy intake, and enteral nutrition energy intake of patients in the two groups at the 3 rd, 7 th, 14 th, and 21 st d after injury were collected (the last two indicators were respectively expressed as the mean values of the 3 rd to 6 th, 7 th to 10 th, 14 th to 17 th, and 21 st to 24 th d after injury). The actual energy intake/REE value and enteral nutrition energy intake/actual energy intake were calculated. Results:The REE values of patients in survival group and death group were (8 143±2 328), (9 843±2 610), (10 149±2 248), (9 608±2 838) kJ and (6 816±2 057), (10 691±2 515), (11 031±2 850), (8 990±2 018) kJ, respectively at the 3 rd , 7 th, 14 th, and 21 st d after injury. The REE value and enteral nutrition energy intake of patients in the two groups showed trends of increase first and decrease then from the 3 rd to 21 st d after injury, while the differences in the above two indicators at each time point between the two groups of patients were not statistically significant ( P>0.05). The actual energy intake of patients in survival group at the 21 st d after injury was significantly higher than that at the 3 rd d after injury ( P<0.05), and the enteral nutrition energy intake of patients in death group at the 14 th d after injury was significantly higher than that at the 3 rd d after injury ( P<0.05). There were no statistically significant differences in overall comparison in actual energy intake/REE value and enteral nutrition energy intake/actual energy intake at each time point after injury between and within the two groups of patients ( P>0.05). The level of IL-6 of patients in survival group at the 21 st d after injury was significantly lower than that at the 3 rd and 7 th d after injury, respectively (with both P values <0.05), and significantly higher than that at the 14 th d after injury ( P<0.05); the level of IL-6 of patients in death group at the 21 st d after injury was significantly higher than that at the 3 rd, 7 th, and 14 th d after injury (with P values all <0.05). The albumin level of patients in survival group at the 7 th d after injury was significantly higher than that at the 3 rd d after injury ( P<0.05). Conclusions:The REE value and enteral nutrition energy intake of extremely severe burn patients showed trends of increase first and decrease then, while they have no significant effects on the clinical outcome of the patients. The nutritional treatment scheme based on the indirect calorimetry can basically meet the energy demand of patients with extremely severe burns during hypermetabolic stage. The impacts of the albumin and IL-6 levels on the clinical outcome of extremely severe burn patients still need further research.
