medigraphic.com
ISSN 2594-1518 (Digital)
ISSN 1405-0099 (Impreso)

2003, Número 2

<< Anterior Siguiente >>

Cir Gen 2003; 25 (2)


Diferencia entre calorías requeridas y administradas en pacientes con pancreatitis aguda grave

Díaz-Pizarro GJI, Athié AAJ, Mijares GJM, Díaz-Reynoso JAR, Cárdenas LLE

Idioma: Español
Referencias bibliográficas: 50
Paginas: 119-124
Archivo PDF: 59.97 Kb.


RESUMEN

Objetivo: Comparar la diferencia diaria entre las calorías requeridas y las administradas de pacientes con pancreatitis aguda grave.
Sede: Hospital de tercer nivel de atención.
Diseño: Estudio prospectivo, descriptivo, abierto y longitudinal.
Pacientes y métodos: Se compararon las calorías administradas con las requeridas (medidas por calorimetría indirecta), diariamente, en 35 pacientes adultos con pancreatitis aguda grave a quienes se les administró apoyo nutricional enteral o parenteral.
Resultados: Se incluyeron 35 pacientes, 16 hombres, 19 mujeres, edad promedio 42.85 (± 17.92) años con pancreatitis aguda grave. A 16 de ellos se les administró apoyo nutricional por vía parenteral y a 19 por vía enteral. Para el cuarto día se administraban 13.06% (224 kcal/día) más calorías de las requeridas por los pacientes, relación que aumentó al disminuir el gasto energético sin modificar el aporte calórico hasta un 27.01% (412 kcal/día).
Conclusión: Existen diferencias entre las calorías requeridas y las administradas en pacientes con pancreatitis aguda grave debido a la variación diaria del gasto energético sin la modificación del aporte calórico. Esta sobrealimentación puede resultar en las complicaciones propias de la hiperalimentación. La calorimetría indirecta puede utilizarse como un monitor metabólico que refleje la evolución del paciente.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Banks PA. Acute pancreatitis. ACG Draft guidelines. 1995: 91-107.

  2. Bradley EL 3rd. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg 1993; 128: 586-90

  3. Mora RJF. Calorimetría indirecta. En: Mora RJF. ed.: Soporte nutricional especial. Colombia: Editorial Médica Panamericana; 1992: 82-8.

  4. Ireton-Jones CS, McClave SA, Spain DA. Should predictive equations or indirect calorimetry be used to design nutrition support regimens? Nutr Clin Pract 1998; 13: 141-5.

  5. Makk LJ, McClave SA, Creech PW, Johnson DR, Short AF, Whitlow NL, et al. Clinical application of the metabolic cart to the delivery of total parenteral nutrition. Crit Care Med 1990; 18: 1320-7.

  6. McClave SA, Lowen CC, Kleber MJ. Are patients fed appropriately according to their caloric requirements? [Abstract]. JPEN J Parenteral Enteral Nutr 1997; 21: S12.

  7. McArthur C. Indirect calorimetry. Respir Care Clin N Am 1997; 3: 291-307.

  8. Matarese LE. Indirect calorimetry: technical aspects. J Am Diet Assoc 1997; 97(10 Suppl 2): S154-60

  9. Wolfe RR, Martini WZ. Changes in intermediary metabolism in severe surgical illness. World J Surg 2000; 24: 639-47.

  10. Weir VBJ. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol 1949; 109: 1-9.

  11. Blackburn GL, Bistrian BR, Maini BS, Schlamm HT, Smith MF. Nutrition and metabolic assessment of the hospitalized patient. JPEN J Parenter Enteral Nutr 1977;1:11-22

  12. Mackenzie TA, Clark NG, Bistrian BR, Flatt JP, Hallowell EM, Blackburn GL. A simple method for estimating nitrogen balance in hospitalized patients: a review and supporting data for a previously proposed technique. J Am Coll Nutr 1985; 4: 575-81.

  13. Jéquier E. Measurement of energy expenditure in clinical nutrition assessment. JPEN J Parenter Enteral Nutr 1987;11(5 Suppl):865-895.

  14. Adam S, Batson S. A study of problems associated with the delivery of enteral feed in critically ill patients in five ICUs in the UK. Intensive Care Med 1997; 23: 261-6.

  15. McClave SA, Sexton LK, Spain DA, Adams JL, Owens NA, Sullins MB, et al. Enteral tube feeding in the intensive care unit: factors impeding adequate delivery. Crit Care Med 1999; 27: 1252-6.

  16. Mathus-Vliegen LM, Binnekade JM, de Haan RJ. Bacterial contamination of ready-to-use 1-L feeding bottles and administration sets in severely compromised intensive care patients. Crit Care Med 2000; 28: 67-73.

  17. Harris MR, Huseby JS. Pulmonary complications from nasoenteral feeding tube insertion in an intensive care unit: incidence and prevention. Crit Care Med 1989; 17: 917-9.

  18. Klausen B, Toubro S, Astrup A. Age and sex effects on energy expenditure. Am J Clin Nutr 1997; 65: 895-907.

  19. Pannemans DL, Bouten CV, Westerterp KR. 24 h energy expenditure during a standardized activity protocol in young and elderly men. Eur J Clin Nutr 1995; 49: 49-56.

  20. Harris JA, Benedict FG. Biometric studies of basal metabolism in man. Washington DC: Carnegie Institution,1919; publication 270.

  21. Banks PA. Acute pancreatitis: medical and surgical management. Am J Gastroenterol 1994; 89(8 Suppl): S78-85.

  22. Banks PA. Medical management of acute pancreatitis and complications. In: Go VLW, eds: The pancreas: Biology, pathobiology, and disease. 2nd edition, Raven Press, New York. 1993: 593-611.

  23. Liu CL, Lo CM, Fan ST. Acute biliary pancreatitis: diagnosis and management. World J Surg 1997; 21: 149-54.

  24. Bassili HR, Deitel M. Effect of nutritional support on weaning patients off mechanical ventilators. JPEN J Parenter Enteral Nutr 1981; 5: 161-3.

  25. Robinson G, Goldstein M, Levine GM. Impact of nutritional status on DRG length of stay. JPEN J Parenter Enteral Nutr 1987; 11: 49-51.

  26. Reilly JJ Jr, Hull SF, Albert N, Waller A, Bringardener S. Economic impact of malnutrition: a model system for hospitalized patients. JPEN J Parenter Enteral Nutr 1988; 12: 371-6

  27. Osborne BJ, Saba AK, Wood SJ, Nyswonger GD, Hansen CW. Clinical comparison of three methods to determine resting energy expenditure. Nutr Clin Pract 1994; 9: 241-6.

  28. Flancbaum L, Choban PS, Sambucco S, Verducci J, Burge JC. Comparison of indirect calorimetry, the Fick method, and prediction equations in estimating the energy requirements of critically ill patients. Am J Clin Nutr 1999; 69: 461-6.

  29. Epstein CD, Peerless JR, Martin JE, Malangoni MA. Comparison of methods of measurements of oxygen consumption in mechanically ventilated patients with multiple trauma: the Fick method versus indirect calorimetry. Crit Care Med 2000; 28: 1363-9.

  30. Case KO, Brahler CJ, Heiss C. Resting energy expenditures in Asian women measured by indirect calorimetry are lower than expenditures calculated from prediction equations. J Am Diet Assoc 1997; 97: 1288-92.

  31. Finan K, Larson DE, Goran MI. Cross-validation of prediction equations for resting energy expenditure in young, healthy children. J Am Diet Assoc 1997; 97: 140-5.

  32. Piers LS, Diffey B, Soares MJ, Frandsen SL, McCormack LM, Lutschini MJ, et al. The validity of predicting the basal metabolic rate of young Australian men and women. Eur J Clin Nutr 1997; 51: 333-7.

  33. Kaplan AS, Zemel BS, Neiswender KM, Stallings VA. Resting energy expenditure in clinical pediatrics: measured versus prediction equations. J Pediatr 1995;127:200-5.

  34. Thomson MA, Bucolo S, Quirk P, Shepherd RW. Measured versus predicted resting energy expenditure in infants: a need for reappraisal. J Pediatr 1995; 126: 21-7.

  35. Shepherd R. Energy expenditure in infants in health and disease. Can J Gastroenterol 1997; 11: 101-4.

  36. Coss-Bu JA, Jefferson LS, Walding D, David Y, Smith EO, Klish WJ. Resting energy expenditure in children in a pediatric intensive care unit: comparison of Harris-Benedict and Talbot predictions with indirect calorimetry values. Am J Clin Nutr 1998; 67: 74-80.

  37. Hernández-Chávez A, Corona-Jiménez F, Gutiérrez-De La Rosa JL, Hernández–Jiménez A, Cumplido-Hernández G, López-Guillén P. El gasto energético en reposo, medido contra estimado, en pacientes críticamente enfermos. Gac Med Mex 1995; 131: 283-8.

  38. Reid CL, Carlson GL. Indirect calorimetry a review of recent clinical applications. Curr Opin Clin Nutr Metab Care 1998; 1: 281-6.

  39. Weissman C, Kemper M. Metabolic measurements in the critically ill. Crit Care Clin 1995; 11: 169-97.

  40. Wells JC, Fuller NJ. Precision and accuracy in a metabolic monitor for indirect calorimetry. Eur J Clin Nutr 1998; 52: 536-40.

  41. Seale JL. Energy expenditure measurements in relation to energy requirements. Am J Clin Nutr 1995; 62(5 Suppl): 1042S-1046S.

  42. Uehara M, Plank LD, Hill GL. Components of energy expenditure in patients with severe sepsis and major trauma: a basis for clinical care. Crit Care Med 1999; 27: 1295-302.

  43. Plank LD, Hill GL. Sequential metabolic changes following induction of systemic inflammatory response in patients with severe sepsis or major blunt trauma. World J Surg 2000; 24: 630-8.

  44. White MS, Shepherd RW, McEniery JA. Energy expenditure measurements in ventilated critically ill children: within- and between-day variability. JPEN J Parenter Enteral Nutr 1999; 23: 300-4.

  45. Monk DN, Plank LD, Franch-Arcas G, Finn PJ, Streat SJ, Hill GL. Sequential changes in the metabolic response in critically injured patients during the first 25 days after blunt trauma. Ann Surg 1996; 223: 395-405.

  46. Bouffard YH, Delafosse BX, Annat GJ, Viale JP, Bertrand OM, Motin JP. Energy expenditure during severe acute pancreatitis. JPEN J Parenter Enteral Nutr 1989; 13: 26-9

  47. Smyrnios NA, Curley FJ, Shaker KG. Accuracy of 30-minute indirect calorimetry studies in predicting 24-hour energy expenditure in mechanically ventilated, critically ill patients. JPEN J Parenter Enteral Nutr 1997; 21: 168-74.

  48. Frankenfield DC, Sarson GY, Blosser SA, Cooney RN, Smith JS. Validation of a 5-minute steady state indirect calorimetry protocol for resting energy expenditure in critically ill patients. J Am Coll Nutr 1996; 15: 397-402.

  49. Cunningham KF, Aeberhardt LE, Wiggs BR, Phang PT. Appropriate interpretation of indirect calorimetry for determining energy expenditure of patients in intensive care units. Am J Surg 1994; 167: 547-9.

  50. Raurich JM, Ibáñez J, Marse P. Producción de CO2 y termogénesis inducidas por la nutrición enteral y parenteral. Nutr Hosp 1996; 11: 108-13.




2020     |     www.medigraphic.com