The Challenge of Developing a New Predictive Formula to Estimate Energy Requirements in Ventilated Critically Ill Children
The Challenge of Developing a New Predictive Formula to Estimate Energy Requirements in Ventilated Critically Ill Children
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DOI：
10.1177/0884533612448479
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发表时间：
2012-10-01
影响因子：
3.1
通讯作者：
Habibi, Parviz
中科院分区：
文献类型：
--
作者：
Meyer, Rosan;Kulinskaya, Elena;Habibi, Parviz
背景：传统上，能源需求是使用预测方程计算的。这些方法不能准确地计算能量消耗。常规间接量热法已被建议，但这种方法在技术上要求很高，成本很高。本研究旨在建立一个新的预测方程来估计危重儿童的能量需求。研究方法：这项前瞻性、观察性研究对通气儿童进行，包括气管内导管泄漏< 10%和吸入氧分数<60%的患者。间接量热法能量消耗测量和多项式回归分析，用于开发新的预测方程。新的公式，然后与现有的预测方程进行了比较。结果：369次测量的数据被纳入公式设计。只有体重和诊断影响能量消耗显着。开发了R-2 > 0.8的三个公式（A、B、C）。当我们将新公式与常用公式（斯科菲尔德、联合国粮农组织/世界卫生组织/联合国大学和白色公式）进行比较时，所有公式的表现都非常相似，但斯科菲尔德公式似乎具有最低的SD。结论：所有3个新的儿科重症监护病房方程的R-2值均> 0.8;然而，斯科菲尔德方程在预测这些患者的能量消耗方面仍优于其他预测方法。尽管如此，没有一个预测方程，包括新方程，预测能量消耗在临床上可接受的范围内，需要进一步的研究，特别是对于间接热量测定技术范围之外的患者。(Nutr临床实践2012;27：669-676）
Background: Traditionally, energy requirements have been calculated using predictive equations. These methods have failed to calculate energy expenditure accurately. Routine indirect calorimetry has been suggested, but this method is technically demanding and costly. This study aimed to develop a new predictive equation to estimate energy requirements for critically ill children. Methods: This prospective, observational study on ventilated children included patients with an endotracheal tube leak of < 10% and fractional inspired oxygen of < 60%. An indirect calorimetry energy expenditure measurement was performed and polynomial regression analysis was used to develop new predictive equations. The new formulas were then compared with existing prediction equations. Results: Data from 369 measurements were included in the formula design. Only weight and diagnosis influenced energy expenditure significantly. Three formulas (A, B, C) with an R-2 > 0.8 were developed. When we compared the new formulas with commonly used equations (Schofield, Food and Agriculture Organization/World Health Organization/United Nations University, and White equation), all formulas performed very similar, but the Schofield equation seemed to have the lowest SD. Conclusions: All 3 new pediatric intensive care unit equations have R-2 values of > 0.8; however, the Schofield equation still performed better than other predictive methods in predicting energy expenditure in these patients. Still, none of the predictive equations, including the new equations, predicted energy expenditure within a clinically accepted range, and further research is required, particularly for patients outside the technical scope of indirect calorimetry. (Nutr Clin Pract. 2012;27:669-676)