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Continuous measurement of energy expenditure in ventilated patients suffering from severe head injury
Authors:M Yano  T Otsuka
Institution:Department of Anesthesiology, Nippon Medical School, Tokyo, Japan.
Abstract:In 9 severe head injuries whose respiration was controlled by a ventilator, continuous measurements of energy expenditure (MEE) were carried out by the ERICA Metabolic Computer. Age was ranged 19 to 69 years old (Mean 48.3 years). Glasgow Coma Scale score was 3 to 11 which were assessed the best score during 6 hours of admission. The MEE was carried out within 7 days of admission and was continued to measure more than 3 days. It measured O2 consumption and CO2 output, and calculated the indirect energy expenditure. The data were displayed and recorded every 1, 15, 60 min. The value of MEE was compared with predicted energy expenditure (PEE) which was calculated by the Harris-Benedict formula. Out of 9 patients, 6 patients were survived. High dose barbiturate therapy was performed in 7 patients to control and decrease the intracranial hypertension. Of them 3 patients died. The value of MEE in all 9 patients was variable from 77% to 212% of PEE. The value of MEE in 6 survived patients was 98.0 to 212.0% of PEE. Out of 6 patients, 4 patients who were administered high dose barbiturate showed variable data of MEE. Two patients showed about 100% of the PEE, one showed about 150%, and another one about 200%. Remaining 2 survivors who were not administered barbiturate showed about 125% of PEE, which was low value. These results were divided into two groups. In 2 patients, the value of MEE was 150% or more in spite of barbiturate therapy. In remaining 7 patients, the value of MEE was 125% or less of PEE.(ABSTRACT TRUNCATED AT 250 WORDS)
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