改良HB系数法指导的营养支持疗法对重症颅脑损伤患者预后的影响

doi:10.20047/j.issn1673-7210.2023.05.25

Abstract
Figure/Table
References (25)
Related Citation (15)

Download: PDF (1191 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the effect of nutritional target support therapy with modified Harris-Benedict (HB) coefficient on the prognosis of patients with severe craniocerebral injury (TBI). Methods A total of 87 severe TBI patients admitted to the Department of Neurosurgery, the First Affiliated Hospital of Nanjing Medical University, the Intensive Care Unit the Fourth Affiliated Hospital of Nanjing Medical University and the Gulou Hospital of Nanjing Medical University from September 2019 to June 2022 were selected. Resting energy expenditure (REE) was measured by respiratory indirect calorimetry (IC) method and HB method of nutritional support. The difference and correlation between the two methods were analyzed, and the linear regression equation of the two methods was obtained (namely improved HB coefficient method formula). In addition, 40 severe TBI patients admitted to the Fourth Affiliated Hospital of Nanjing Medical University from June 2022 to September were selected and they were divided into IC group and modified HB coefficient method group according to the random number table method, and the prognostic indicators of the two groups were compared. Results The REE values of severe TBI patients were measured by IC and HB coefficient method 316 times respectively within two weeks of nutritional support treatment. The REE values obtained by IC method were significantly higher than those obtained by HB coefficient method (P＜0.05); the modified HB coefficient regression equation based on IC method was Y = 0.68X+767.67 (unit: kJ/d, X was the REE calculated by HB coefficient method of severe TBI patients ). There was no significant difference in the the modified HB coefficient method group and IC method group (P＞0.05). Conclusion The HB coefficient method significantly underestimated the energy expenditure of severe TBI patients within two weeks of the course of the disease. The modified HB coefficient method by IC method can more accurately estimate the energy expenditure of severe TBI patients, and provide accurate and simple nutritional support for clinical practice.

Key words： Craniosynostosis Energy metabolism HB coefficient Indirect calorimetry

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	GAO Tian1 WANG Wei1 GU Qin2 HUANG Peizan1 WANG Ling1 WANG Dan1 WANG Huibo3 LI Hailin4

Cite this article:

GAO Tian1 WANG Wei1 GU Qin2 HUANG Peizan1 WANG Ling1 WANG Dan1 WANG Huibo3 LI Hailin4. Effect of nutritional target support therapy with modified HB coefficient on the prognosis of patients with severe craniocerebral injury[J]. 中国医药导报, 2023, 20(5): 106-110.

URL:

https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.05.25 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I5/106

[1] Cash A，Theus MH. Mechanisms of Blood-Brain Barrier Dysfunction in Traumatic Brain Injury [J]. Int J Mol Sci，2020， 21（9）：3344.
[2] Jin T，Lian W，Xu K，et al. Effect of combination invasive intracranial pressure （ICP） monitoring and transcranial Doppler in the treatment of severe craniocerebral injury patients with decompressive craniectomy [J]. Ann Palliat Med，2021，10（4）：4472-4478.
[3] Khatri N，Thakur M，Pareek V，et al. Oxidative Stress：Major Threat in Traumatic Brain Injury [J]. CNS Neurol Disord Drug Targets，2018，17（9）：689-695.
[4] Ladak AA，Enam SA，Ibrahim MT. A Review of the Molecular Mechanisms of Traumatic Brain Injury [J]. World Neurosurg，2019，131：126-132.
[5] Du T，Jing X，Song S，et al. Therapeutic Effect of Enteral Nutrition Supplemented with Probiotics in the Treatment of Severe Craniocerebral Injury：A Systematic Review and Meta-Analysis [J]. World Neurosurgery，2020，139：e553- e571.
[6] Hanscom M，Loane DJ，Shea-Donohue T. Brain-gut axis dysfunction in the pathogenesis of traumatic brain injury [J]. J Clin Invest，2021，131（12）：e143777.
[7] Moonen HPFX，Beckers KJH，van Zanten ARH. Energy expenditure and indirect calorimetry in critical illness and convalescence current evidence and practical considerations [J]. J Intensive Care，2021，9（1）：8.
[8] Wischmeyer PE，Molinger J，Haines K. Point-Counterpoint：Indirect Calorimetry Is Essential for Optimal Nutrition Therapy in the Intensive Care Unit [J]. Nutr Clin Pract，2021，36（2）：275-281.
[9] 王丽娟，赵兰菊，杨小娟，等.间接测热法与HB公式法测定多发伤机械通气患者能量消耗的一致性研究[J].中华危重病急救医学，2018，30（10）：946-949.
[10] De Waele E，Jonckheer J，Wischmeyer PE. Indirect calorimetry in critical illness：a new standard of care? [J]. Curr Opin Crit Care，2021，27（4）：334-343.
[11] Robinson CP. Moderate and Severe Traumatic Brain Injury [J]. Continuum （Minneap Minn），2021，27（5）：1278-1300.
[12] Oliveira ACDS，de Oliveira CC，de Jesus MT，et al. Comparison of Equations to Predict Energy Requirements With Indirect Calorimetry in Hospitalized Patients [J]. JPEN J Parenter Enteral Nutr，2021，45（7）：1491-1497.
[13] 高明，周华，朱研，等.间接测热法与预测公式对肝脏术后患者能量消耗评估的差异性分析[J].临床急诊杂志，2021，22（1）：4.
[14] 卓缘圆，王鑫茹，黄聪聪，等.脑梗死和脑出血1年复发风险比较和危险因素分析[J].中国医药导报，2022，19（23）：74-78.
[15] 李娅，李辉凤，王铭，等.严重创伤并发持续炎症-免疫抑制-分解代谢综合征的研究进展[J].中国急救医学，2021，41（4）：5.
[16] LoBue C，Munro C，Schaffert J，et al. Traumatic Brain Injury and Risk of Long-Term Brain Changes， Accumulation of Pathological Markers，and Developing Dementia：A Review [J]. J Alzheimers Dis，2019，70（3）：629-654.
[17] Wang H，He Y，Liang R，et al. A meta-analysis and systematic review of intracranial pressure monitoring on severe craniocerebral injury [J]. Ann Palliat Med，2021，10（5）：5380-5390.
[18] Cook AM，Peppard A，Magnuson B. Nutrition Considerations in Traumatic Brain Injury [J]. Nutrition in clinical practice，2008，23（6）：608-620.
[19] Killen MJ，Giorgi-Coll S，Helmy A，et al. Metabolism and inflammation： implications for traumatic brain injury therapeutics [J]. Expert Rev Neurother，2019，19（3）：227-242.
[20] Kolb H，Kempf K，R?觟hling M，et al. Ketone bodies：from enemy to friend and guardian angel [J]. BMC Med，2021，19（1）：313.
[21] Chapple LS，Weinel L，Ridley EJ，et al. Clinical Sequelae From Overfeeding in Enterally Fed Critically Ill Adults： Where Is the Evidence? [J]. JPEN J Parenter Enteral Nutr，2019，44（6）：980-991.
[22] Duan JY，Zheng WH，Zhou H，et al. Energy delivery guided by indirect calorimetry in critically ill patients：a systematic review and meta-analysis [J]. Crit Care，2021，25（1）：88.
[23] Taylor BE，McClave SA，Martindale RG，et al. Society of Critical Care Medicine; American Society of Parenteral and Enteral Nutrition. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient：Society of Critical Care Medicine（SCCM）and American Society for Parenteral and Enteral Nutrition （A.S.P.E.N.） [J]. Crit Care Med，2016，44（2）：390-438.
[24] Smetana KS，Hannawi Y，May CC. Indirect Calorimetry Measurements Compared With Guideline Weight-Based Energy Calculations in Critically Ill Stroke Patients [J]. JPEN J Parenter Enteral Nutr，2021，45（7）：1484-1490.
[25] Wu S，Iqbal S，Giroux M，et al. Penn State equation versus indirect calorimetry for nutritional assessment in patients with traumatic brain injury [J]. Can J Surg，2022，65（3）：E320-E325.