Energy expenditure and energy intake – Guidelines on Parenteral Nutrition, Chapter 3Energieumsatz und Energiezufuhr – Leitlinie Parenterale Ernährung, Kapitel 3

GMS German Medical Science — an Interdisciplinary Journal

M. J. Mueller²  M. Adolph¹  G. Kreymann³ 

[1] Dept. of Anaesthesiology and Intensive Medicine, EberhardKarl University, Tuebingen, Germany;Institute for Human Nutrition and Food Science, ChristianAlbrechtsUniversity of Kiel, Germany;Dept. of Medicine, Univ. of Hamburg, Germany

关键词: intensive care;    critically ill;    sepsis;    energy requirements;   

Others  :  869105

实施日期：2009-01-14，发布日期：2009-11-18

【 摘 要 】

The energy expenditure (24h total energy expenditure, TEE) of a healthy individual or a patient is a vital reference point for nutritional therapy to maintain body mass. TEE is usually determined by measuring resting energy expenditure (REE) by indirect calorimetry or by estimation with the help of formulae like the formula of Harris and Benedict with an accuracy of ±20%. Further components of TEE (PAL, DIT) are estimated afterwards. TEE in intensive care patients is generally only 0–7% higher than REE, due to a low PAL and lower DIT. While diseases, like particularly sepsis, trauma and burns, cause a clinically relevant increase in REE between 40–80%, in many diseases, TEE is not markedly different from REE. A standard formula should not be used in critically ill patients, since energy expenditure changes depending on the course and the severity of disease. A clinical deterioration due to shock, severe sepsis or septic shock may lead to a drop of REE to a level only slightly (20%) above the normal REE of a healthy subject. Predominantly immobile patients should receive an energy intake between 1.0–1.2 times the determined REE, while immobile malnourished patients should receive a stepwise increased intake of 1.1–1.3 times the REE over a longer period. Critically ill patients in the acute stage of disease should be supplied equal or lower to the current TEE, energy intake should be increased stepwise up to 1.2 times (or up to 1.5 times in malnourished patients) thereafter.

【 授权许可】

   
© 2009 Kreymann et al.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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