Metabolic Cart For Measuring The Energy Metabolism In Severely Burned Patients

Objective: To discuss the value of metabolic cart by measuring the resting energy expenditure(REE, kcal /d) in severely burned patients and analyze the effects of burns area, severity of illness and operation in REE.Methods: 20 cases of severe burns from August 2014 to January 2015 were involved in this program, They were all belong to Critical Care Medicine Department of Suzhou Municipal Hospital and all token mechanical ventilation therapy. On the 1st, the 3rd, the 7th, the 14 th and 28 th day, metabolic cart measured resting energy expenditure(m REE, kcal /d) in severely burned patients and compared with predict resting energy expenditure(p REE, kcal /d) calculated from the H-B formula multipling the stress factor; at the same time we compared the m REE of 28-day-survival group and 28-day-death group, Ⅲ degree burns> 90% group and Ⅲ degree burns <20% group, APACHEⅡ score ≥15 points group and APACHEⅡ <15 points group, before and after the 1st 24 hours of the operation.Result: 1. The m REE amounts of patients were between p REE1.5(stress factor of 1.5) and p REE 2.0(stress factor of 2.0) on the 1st, the 3rd, the 7th, the 14 th and 28 th day. Compared with p REE1.5, the m REE amounts were significantly different(P<0.05). Compared with p REE 2.0, the m REE amounts were significantly different on the 1st, the 3rd, 7th day(P <0.05), the other days were not(P> 0.05). 2. 28-day-survival group and 28-day-death group showed no significant difference in the m REE(P> 0.05). 3. The m REE in Ⅲ degree burns> 90% group were higher than Ⅲ degree burns <20% group and were significantly different on the 1st, the 3rd and the 28 th day(P <0.05), but on the 7th and the 14 th day were not(P> 0.05). 4, The m REE in APACHEⅡ≥15 group were significantlyhigher than APACHEⅡ <15 group(P<0.05). 5.The levels of m REE after the operation were significantly lower than before(P <0.05).Conclusion: 1, The resting energy expenditure in severely burned patients measured by metabolic cart and calculated by H-B formula multipling the stress factor were not exactly the same. 2, Burns area, severity of illness, operation possibly impact on the levels of REE.