Prognostic value of respiratory quotients in severe polytrauma patients with nutritional support
Language English Country United States Media print-electronic
Document type Journal Article, Observational Study, Research Support, Non-U.S. Gov't
PubMed
29500970
DOI
10.1016/j.nut.2017.10.013
PII: S0899-9007(17)30239-3
Knihovny.cz E-resources
- Keywords
- Duration of mechanical ventilation, Energy expenditure, Energy metabolism, ICU length of stay, Indirect calorimetry, Intensive care unit,
- MeSH
- Basal Metabolism MeSH
- Time Factors MeSH
- Length of Stay statistics & numerical data MeSH
- Adult MeSH
- Energy Metabolism MeSH
- Intensive Care Units MeSH
- Middle Aged MeSH
- Humans MeSH
- Calorimetry, Indirect methods statistics & numerical data MeSH
- Fasting MeSH
- Parenteral Nutrition statistics & numerical data MeSH
- Pilot Projects MeSH
- Multiple Trauma physiopathology therapy MeSH
- Prognosis MeSH
- Prospective Studies MeSH
- Regression Analysis MeSH
- Respiratory Function Tests methods statistics & numerical data MeSH
- Respiration, Artificial statistics & numerical data MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVE: The association between energy metabolism and prognosis in polytrauma patients has not yet been defined. The aim of this study was to describe energy metabolism and analyze the prognostic value of respiratory quotient (RQ) and nonprotein respiratory quotient (npRQ) in fasting polytrauma patients (fPP) and polytrauma patients with nutritional support (nsPP). METHODS: Twenty-two polytrauma patients (before and after parenteral nutrition administration) and 22 healthy controls (after overnight fasting) were examined on day 4 (median) after admission to the intensive care unit. To evaluate energy expenditure in nsPP and resting energy expenditure in fPP and controls with RQ and npRQ in all groups, we used indirect calorimetry. With regression analysis, the descriptive models of intensive care unit (ICU) length of stay (LOS) and mechanical ventilation time (VT) were derived. RESULTS: RQ and npRQ were significantly lower in fPP than in controls (P < 0.05 and P < 0.01, respectively) and in nsPP (P < 0.05). In nsPP, relationships between RQ or npRQ and the ICU LOS or mechanical VT were demonstrated (P < 0.0001, r = -0.78 for RQ and VT; P < 0.0001, r = -0.78 for npRQ and VT; P < 0.001, r = -0.69 for RQ and LOS; P < 0.001, r = -0.72 for npRQ and LOS). CONCLUSIONS: RQ and npRQ parameters measured by indirect calorimetry in polytrauma patients with parenteral nutrition on the fourth day of ICU stay related to clinical outcomes such as duration of mechanical ventilation and ICU LOS.
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