AJP - Endocrinology and Metabolism, Vol 267, Issue 6 E1002-E1009, Copyright © 1994 by American Physiological Society
A new method for the estimation of the components of energy expenditure in patients with major trauma
G. Franch-Arcas, L. D. Plank, D. N. Monk, R. Gupta, K. Maher, L. Gillanders and G. L. Hill
University Department of Surgery, Auckland Hospital, New Zealand.
The management of critically ill patients would be better understood if the
total energy expenditure (TEE) and its components are known. To quantify
the different components of energy expenditure in patients with major
trauma, we used a technique combining measurements of body composition and
oxygen consumption. We determined changes in body weight, total body water,
total body protein, total body potassium, total body fat, and bone mineral
content every 5 days over a 10-day period in a group of nine multiply
injured patients. Resting energy expenditure was measured by indirect
calorimetry (REEm), and a predicted value was obtained from total body
potassium (REEp). TEE was assessed by adding the total calorie intake to
the changes in body energy stores, and the activity energy expenditure
(AEE) was calculated by subtracting REEm from TEE. Mean daily values for
REEm, REEp, TEE, and AEE were 2,236 +/- 140, 1,683 +/- 82, 3,029 +/- 276,
and 793 +/- 213 kcal/day, respectively, over the 10-day study period.
Although not statistically significant, the mean AEE was four times smaller
for the first 5 days of study than for the second 5 days (298 +/- 400 vs.
1,254 +/- 588 kcal/day). The technique of combining indirect calorimetry
and body composition measurements offers a new approach to evaluate energy
expenditure and a new way to study metabolic disorders and therapeutic
strategies in critically ill patients.
