INFLUENCE OF ARTIFICIAL LUNG VENTILATION ON REAL ENERGY EXPENDITURE VALUE OF SURGICAL INTENSIVE CARE UNIT PATIENTS
https://doi.org/10.24060/2076-3093-2017-7-2-16-21
Abstract
Elective or emergence surgery often is closely connected with development of hypercatabolism-hypermetabolism syndrome. Non-effective and late nutritional support in surgical critically ill patients lead to several consequences and complications such as: wound and nosocomial infectons, gastric stress ulcers, pressure ulcers, prolonged artificial lung ventilation, increased length of stay in ICU and hospital. Energy deficit is one of the important components of critical illness and it corresponds with multiple organ dysfunction progression. Prospective study was provided in 18 beds surgical intensive care unit (SICU). 106 patient medical cards were divided into 4 groupstwo control and two basic with espiratory support (subgroup with artificial lung ventilation and subgroup without artificial lung ventilation). We compared the effectiviness of two methods for the estimation of patients energy needsspecial equations and indirect calorimetry. As a result we found out that main markers of energy and protein metabolism and nutritive status were significantly higher in indirect calorimetry groupswith and without artificial lung ventilation. Conclusion: Indirect calorimetry method usage for the estimation of energy needs in surgical ICU patients is more effective than special equations method during first 7 days of critical illness and may be recommended for clinical practice implication.
About the Authors
I. V. Polyakov
G.G. Kuvatov Republican Clinical Hospital
Russian Federation
Russian Federation
Polyakov Igor Viacheslavovich - Physician of Surgical Intensive Care Unit
Ufa
K. N. Zolotukhin
G.G. Kuvatov Republican Clinical Hospital
Russian Federation
Russian Federation
Zolotukhun Konstantin Nicolaevich - Candidate of Medical Sciences, Chief of Surgical Intensive Care Unit
Ufa
I. N. Leyderman
Ural State Medical University
Russian Federation
Russian Federation
Leyderman Ilya Naumovich - Doctor of Medical Sciences, Professor of Anesthesia and Critical Care Chair
Ekaterinburg,
References
1. Лейдерман ИН, Левит АЛ, Белкин АА. Принципы создания стандартных алгоритмов нутритивной поддержки в практике отделений реанимации и интенсивной терапии. Тихоокеанский медицинский журнал. 2006;(4):39-42. [Leiderman IN, Levit AL, Belkin AA. Principles of creation of standard algorithms and nutritive support in practice of ICU. Pacific Med J. 2006;(4):39-42 (in Russ.)].
2. Лейдерман ИН, Левит АЛ, Левит ДА, Евреш МА. Современная нутритивная поддержка в хирургии и интенсивной терапии. Стандартные алгоритмы и протоколы: руководство для врачей. Екатеринбург; 2004.
3. Величко ДС. Состояние систем энергообеспечения во взаимосвязи с клиниколабораторными проявлениями расстройств гемостаза у реанимационных больных. Вестник интенсивной терапии.2010;(5):34.
4. Kreymann KG, Berger MM, Deutz NE, Hiesmayr M, Jolliet P, Kazandjiev G, et al. ESPEN guidelines on enteral nutrition: intensive care. Clin Nutr. 2006;25:210-23. DOI: 10.1016/j.clnu.2006.01.021.
5. Berger MM, Chiole ro RL. Hypocaloric feeding: pros and cons. Curr Opin Crit Care. 2007; 13:180-86. DOI: 10.1097/MCC.0b013e3280895d47.
6. Dvir D, Cohen J, Singer P. Computerized energy balance and complications in critically ill patients: an observational study. Clin Nutr. 2005;25:37-44. DOI: 10.1016/j.clnu.2005.10.010.
7. Золотухин КН, Поляков ИВ, Самородов АВ. Сравнительный анализ мониторинга центральной гемодинамики монитором МПР 6-03 «Тритон» и «Picco Plus». Тольяттинский Медицинский Консилиум. 2012;(3-4):19-23. [Zolotukhin KN, Polyakov IV, Samorodov AV. Comparative analysis of circulatory dynamics monitoring with heartbeat monitor «Triton» vs. «PiccoPlus». Togliatti Medical Consultation. 2012;34:19-23 (in Russ.)].
8. Золотухин КН, Поляков ИВ, Самородов АВ. Мониторинг энергозатрат у пациентов с печеночной недостаточностью после абдоминальных оперативных вмешательств в условиях ОРИТ. Тольяттинский Медицинский Консилиум. 2013;(1-2):15-18. [Zolotukhin KN, Polyakov IV, Samorodov AV. Energy consumption monitoring in patients with liver failure after abdominal surgery in the ICU. Togliatti Medical Consultation. 2013;(1-2):15-18 (in Russ.)].
9. AARC clinical practice guideline. Revision and update. Metabolic measurement using indirect calorimetry during mechanical ventilation. Respir Care. 2004;49(9):1073-79.
10. Haugen HA. Indirect calorimetry: a practical guide for clinicians. Nutr Clin Pract. 2007;22(4):37788. DOI: 10.1177/0115426507022004377.
11. Салтанова АИ, Попова ТС, Шестопалова АЕ, (ред.). Парентеральное и энтеральное питание. Национальное руководство. М.: ГЭОТАР-Медиа; 2013.
Review
For citations:
Polyakov I.V., Zolotukhin K.N., Leyderman I.N. INFLUENCE OF ARTIFICIAL LUNG VENTILATION ON REAL ENERGY EXPENDITURE VALUE OF SURGICAL INTENSIVE CARE UNIT PATIENTS. Creative surgery and oncology. 2017;7(2):16-21. (In Russ.) https://doi.org/10.24060/2076-3093-2017-7-2-16-21
Views:
7249
Email this article 