The Study Of Resting Energy Expenditure In Pediatric Sepsis

Background and Objective: The energy that the patients with sepsis consume is estimated mainly depend on forecasting formula during the treatment. But the existing forecasting formulas can’t evaluate their energy consumption accurately and effectively. So it cannot provide the precise plan for the next step nutrition support. Currently the indirect method of energy metabolism estimating children with sepsis of the energy consumption has been getting more and more clinical attention because of its accuracy. This research is to compare the indirect method of energy metabolism with the common predictor formula, and analyze the application of indirect method of energy metabolism in children with sepsis, provide certain reference for the plan of the clinical nutrition support.Method:From November 1, 2013 to December 31, 2014 the Hunan Children’s Hospital received 105 cases of children with sepsis for the research in ICU admission, to use MEDGRAPHICS American company CCM/CPX the Express indirect energy metabolism system to comfirm the person with sepsis of marasmatic energy in the resting, it was analyzed with the predicted value which with clinical commonly used forecast(formula) Harris-Benedict the H-B formula, the Schofield-HTWT formula and the Mifflin formula to compare the difference between the different sex and different type of children with sepsis of practical energy consumption and to observe the albumin, globulin, glutamic-pyruvic transaminase, C- reactive protein, procalcitonin, arterial blood oxygen partial pressure, arterial blood CO2 partial pressure and round-the-clock energy supply and the resting energy expenditure and the correlation of respiratory quotient that are related.Result: The children with sepsis resting energy expenditure measured value and HB formula and Schofield-HTWT formula is the expected value of no statistically significant difference between the values(P>0.05), and the Mifflin formula is expected to have a statistically significant difference between the values(P<0.05). The HB formula is no significant correlation with the value measured value(P>0.05), Schofield-HTWT formula and Mifflin formula for the expected value has significant correlation with the measured values(P<0.00). Different gender, different types of sepsis with in children the difference between the actual energy consumption of no statistical significance(P > 0.05).The results showed that 59% of patients in the high metabolic state, 22% of patients in the normal metabolic state about 19% of the patients in the low metabolic state. The study also revealed that, resting energy expenditure and respiratory quotient and albumin, globulin, glutamic-pyruvic transaminase, Creactive protein, procalcitonin, P02 and PCO2 showed no significant correlation(P>0.05), resting energy expenditure and all day energy supply does not exist significant correlation(P>0.05), and respiratory quotient has a significant correlation with the all day energy supply(P<0.05).Conclusion: 1. Formula method to measured the sepsis syndrome in children with differences between resting energy expenditure estimates to predict appropriate nutritional of support lead to malnutrition or over-nutrition on clinical should defer to the n clinical should defer to the actual energy consumption value which the indirect calorimetry obtains to provide the energy, in three commonly formulas, the Schofield-HTWT formula of accuracy is highest, Without using indirect calorimetry of conditions, we recommend that you select Schofield-HTWT formula to determine the resting energy expenditure of expected value. 2 It does not have the difference between the different sex and different type of sepsis in measured values of resting energy expenditure 3. All day energy of supply have influence for respiratory quotient, but can’t use to guide nutritional to supply treatment.