Author Of 1 Presentation
ESTIMATION OF METABOLIC RATE IN CHILDREN WITH SEVERE MECHANICAL TRAUMA
Abstract
Background
Nutrition is one of the cornerstones of intensive care. Working out an individual nutritive program requires estimation of patient’s nutritive status, anthropometric parameters, daily protein needs, basal metabolic rate. Severe mechanical trauma (SMT), especially with leading brain injury, and furthermore accompanied with SIRS increases metabolic rate. On the contrary, spinal trauma with tetraplegia decreases it. Moreover, intensive care in patients with SMT includes drug-induced sleep, MLV, inotropic support, artificial hypothermia, each of these methods has impact on metabolic rate. We have to define current metabolic rate exactly to avoid hypo- or hyper alimentation.
Objectives
The aim of the study was to compare calculated and measured metabolic rate in children with SMT and to show a correspondence between metabolic rate and trauma structure, neurological status, SIRS and particularities of intensive care.
Methods
Our study includes 50 patients with SMT. Using Quarksline metabolograph we provided several metabolic rate measurements for each of them. The measured values were compared to calculated values of metabolic rate.
Results
The comparison showed that measured values were lower than calculated ones. SIRS, inotropic support lead to increase in energy needs while sedation, MLV, hypothermia and neurological deficit (such as tetraplegia or vegetative status) decreases metabolic rate. Under the influence of various factors current metabolic rate lies in a narrow range and changes quickly.
Conclusion
Indirect calorimetry seems to be an objective method of metabolic rate evaluation.