| Background and purpose:Children with severe pneumonia disease outcomes and basic situation of sick children have close relationship, the related research found that sick children ability metabolism is the base of the influence factors of prognosis and outcome. Under the mechanical ventilation treatment of children with energy metabolism and nutrition support treatment is the key step in the clinical comprehensive treatment of the disease. This article focuses on the children with mechanical ventilation treatment of severe pneumonia resting energy expenditure of the metabolism and H- B formula measurement, to determine treatment in children with the energy required, and on this basis, a treatment. Aim is to:(1) compared with H- B formula car metabolism method was developed for the determination of mechanical ventilation energy consumption value children with severe pneumonia.(2) discuss two methods of energy measurement in mechanical ventilation in the treatment of children with severe pneumonia nutrition support.Methods :from December 2013 to December 2014 in hunan children’s hospital of pediatrics collection treatment of 100 cases of children with severe pneumonia and the breathing machine study, adopt the way of grouping cross-sectional study was carried out on the children with the investigation. All of them with the method of mechanical ventilation treatment, children with severe pneumonia were randomly divided into two groups, A and B in each group: 50 cases in group A: determination of metabolic car resting energy expenditure, according to the result of determination of nutritional support treatment. Group B: H-B the formula to calculate the energy consumption, and nutritional support treatment. Respectively on the basis of the two methods to determine energy demand value give nutritional support treatment. For children with REE value, plasma protein, pulmonary function and blood gas analysis, disease prognosis related indicators(ICU length of hospital stay, mortality, the incidence of respiratory related pneumonia, out of breathing machine time, etc.) were observed. Using SPSS18.0 professional statistical software system for evaluating and analyzing research data count data by chi-square test, expressed as a %, measurement data to x + s said, using t test; There are significant difference(P < 0.05) said statistical significance.Results:(1) the experimental group with REE in 1, 3, 5 d measuring average is lower than the control group, after statistics analysis difference significant(P < 0.05); 7 d experimental group with similar REE and the control group(P > 0.05), no difference between the statistics.(2) from the point of blood gas analysis, the experimental group with Pa O2 and BE value was increased the difference compared with control group, after statistics analysis difference significant(P < 0.05), the experimental group of children with Pa CO2, PH, LAC, and GLU was to reduce the difference comparison, through the statistical analysis of two groups of blood gas analysis index declines differences before and after the treatment(P < 0.05). From infection metrics, the experimental group of children with CRP and PCT, the WBC, LYM, NEU and blood sedimentation difference comparison, after statistics analysis meaningful difference(P < 0.05). From the point of plasma protein, the experimental group with plasma albumin, blood plasma globulin and plasma protein increases the difference compared with control group, before was significant difference after statistics analysis(P < 0.05). Experimental group with the plasma total protein before and after treatment to reduce difference compared with control group, after statistics analysis difference significant(P < 0.05). The experimental group after treatment the patient’s blood gas analysis index, infection index and plasma proteins were higher than control group in the proportion of the value of the return to normal, after statistics analysis difference significant(P < 0.05).(3) the experimental group with ICU admission time, out of breathing machine time shorter than the control group, the incidence of ventilator associated pneumonia is lower than the control group, the more significant difference(P > 0.05). Experimental group with total hospital was shorter than the control group, P < 0.05, statistically significant difference.Conclusion:①Low metabolic cart measured REE energy is H-Bformula, compared with the traditional H-B formula, resting energyexpenditure in indirect energy metabolism method for the determinationof the results is more accurate, more close to normal children. ② In thesevere pneumonia mechanical ventilation children with nutritionalintervention, inflammatory index improved, improve the prognosis ofthe disease, it is recommended to use metabolic guidance for clinicaltreatment. |
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