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Establishment and assessment of new formulas for energy consumption estimation in adult burn patients.

Xi P, Kaifa W, Yong Z, Hong Y, Chao W, Lijuan S, Hongyu W, Dan W, Hua J, Shiliang W - PLoS ONE (2014)

Bottom Line: The new formulas were compared with measured REE and commonly used formulas including those of Carlson, Xie, Curreri, and Milner to determine accuracy and reliability.The accuracy of the new nonlinear formula (94.29%) and that of the linear formula (91.43%) were significantly higher than that of Milner formula (72.86%) when compared to measured REE (χ2  =  11.706, P  =  0.001; χ2  =  8.230, P  =  0.004, respectively).The reliabilities of the new estimation formulas were both 100% and that of Milner formula was 74.24% (χ2  =  19.513, P  =  0.000).

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burns of PLA, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China.

ABSTRACT

Objective: An accurate knowledge of energy consumption in burn patients is a prerequisite for rational nutrition therapy. This study sought to create a formula that accounts for the metabolic characteristics of adult burn patients to accurately estimate energy consumption of patients with different areas and extents of burn and at different times after injury.

Methods: Resting energy expenditure (REE) data on 66 burn patients, with total body surface area (TBSA) of burns ranging from 4% to 96%, were evaluated at different times after injury. REE values were determined in patients using indirect calorimetry at days 1, 2, 3, 7, 14, 21, and 28 after injury. We then constructed a mathematical model of REE changes post-burn. Next, established two new formulas (one non-linear and the other linear) for energy consumption estimation using model-based analytical solution and regression analysis. The new formulas were compared with measured REE and commonly used formulas including those of Carlson, Xie, Curreri, and Milner to determine accuracy and reliability.

Results: Comparative analysis showed that the new formulas offered significantly higher accuracy and reliability than the Milner formula, which is considered the most accurate of commonly used burn energy consumption estimate formulas. The accuracy of the new nonlinear formula (94.29%) and that of the linear formula (91.43%) were significantly higher than that of Milner formula (72.86%) when compared to measured REE (χ2  =  11.706, P  =  0.001; χ2  =  8.230, P  =  0.004, respectively). The reliabilities of the new estimation formulas were both 100% and that of Milner formula was 74.24% (χ2  =  19.513, P  =  0.000).

Conclusion: The new formulas constructed in this study provide reliable simulation of the impact of the degree of burn and post-burn days on energy consumption and offer notably higher accuracy and reliability than other formulas. These formulas will help determine nutritional needs of burn patients.

Trial registration: The study was registered on Chinese Clinical Trial Registry as ChiCTR-TRC-13003806.

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Related in: MedlinePlus

Reliabilities of different formulas.The solid line represents the ideal case of complete match between REE estimates and REE measurements (), and the dashed lines represent 20% over or below the ideal match. Data points that fall between the two dashed lines are indicated by blue “*”; those outside are indicated by red “o”. Percentage represents the proportion of data points that fell between the two dashed lines. MEE, measured resting energy expenditure.
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pone-0110409-g004: Reliabilities of different formulas.The solid line represents the ideal case of complete match between REE estimates and REE measurements (), and the dashed lines represent 20% over or below the ideal match. Data points that fall between the two dashed lines are indicated by blue “*”; those outside are indicated by red “o”. Percentage represents the proportion of data points that fell between the two dashed lines. MEE, measured resting energy expenditure.

Mentions: In addition, the overall reliabilities of the new estimation formulas were both 100% (Figure 4). Thus, the REE estimates for each of the 66 patients were located within the range of 20% above or below REE measurements. In contrast, as shown in Figure 4, the overall reliabilities of estimates obtained with the other formulas were significantly worse, with the Milner formula the most reliable (74.24%) and the Curreri formula the least (37.88%). The chi-square tests showed that the reliability of the Milner formula was also significantly lower than that of our new estimation formulas (χ2  =  19.513, P  =  0.000, Figure 3).


Establishment and assessment of new formulas for energy consumption estimation in adult burn patients.

Xi P, Kaifa W, Yong Z, Hong Y, Chao W, Lijuan S, Hongyu W, Dan W, Hua J, Shiliang W - PLoS ONE (2014)

Reliabilities of different formulas.The solid line represents the ideal case of complete match between REE estimates and REE measurements (), and the dashed lines represent 20% over or below the ideal match. Data points that fall between the two dashed lines are indicated by blue “*”; those outside are indicated by red “o”. Percentage represents the proportion of data points that fell between the two dashed lines. MEE, measured resting energy expenditure.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4199722&req=5

pone-0110409-g004: Reliabilities of different formulas.The solid line represents the ideal case of complete match between REE estimates and REE measurements (), and the dashed lines represent 20% over or below the ideal match. Data points that fall between the two dashed lines are indicated by blue “*”; those outside are indicated by red “o”. Percentage represents the proportion of data points that fell between the two dashed lines. MEE, measured resting energy expenditure.
Mentions: In addition, the overall reliabilities of the new estimation formulas were both 100% (Figure 4). Thus, the REE estimates for each of the 66 patients were located within the range of 20% above or below REE measurements. In contrast, as shown in Figure 4, the overall reliabilities of estimates obtained with the other formulas were significantly worse, with the Milner formula the most reliable (74.24%) and the Curreri formula the least (37.88%). The chi-square tests showed that the reliability of the Milner formula was also significantly lower than that of our new estimation formulas (χ2  =  19.513, P  =  0.000, Figure 3).

Bottom Line: The new formulas were compared with measured REE and commonly used formulas including those of Carlson, Xie, Curreri, and Milner to determine accuracy and reliability.The accuracy of the new nonlinear formula (94.29%) and that of the linear formula (91.43%) were significantly higher than that of Milner formula (72.86%) when compared to measured REE (χ2  =  11.706, P  =  0.001; χ2  =  8.230, P  =  0.004, respectively).The reliabilities of the new estimation formulas were both 100% and that of Milner formula was 74.24% (χ2  =  19.513, P  =  0.000).

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burns of PLA, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China.

ABSTRACT

Objective: An accurate knowledge of energy consumption in burn patients is a prerequisite for rational nutrition therapy. This study sought to create a formula that accounts for the metabolic characteristics of adult burn patients to accurately estimate energy consumption of patients with different areas and extents of burn and at different times after injury.

Methods: Resting energy expenditure (REE) data on 66 burn patients, with total body surface area (TBSA) of burns ranging from 4% to 96%, were evaluated at different times after injury. REE values were determined in patients using indirect calorimetry at days 1, 2, 3, 7, 14, 21, and 28 after injury. We then constructed a mathematical model of REE changes post-burn. Next, established two new formulas (one non-linear and the other linear) for energy consumption estimation using model-based analytical solution and regression analysis. The new formulas were compared with measured REE and commonly used formulas including those of Carlson, Xie, Curreri, and Milner to determine accuracy and reliability.

Results: Comparative analysis showed that the new formulas offered significantly higher accuracy and reliability than the Milner formula, which is considered the most accurate of commonly used burn energy consumption estimate formulas. The accuracy of the new nonlinear formula (94.29%) and that of the linear formula (91.43%) were significantly higher than that of Milner formula (72.86%) when compared to measured REE (χ2  =  11.706, P  =  0.001; χ2  =  8.230, P  =  0.004, respectively). The reliabilities of the new estimation formulas were both 100% and that of Milner formula was 74.24% (χ2  =  19.513, P  =  0.000).

Conclusion: The new formulas constructed in this study provide reliable simulation of the impact of the degree of burn and post-burn days on energy consumption and offer notably higher accuracy and reliability than other formulas. These formulas will help determine nutritional needs of burn patients.

Trial registration: The study was registered on Chinese Clinical Trial Registry as ChiCTR-TRC-13003806.

Show MeSH
Related in: MedlinePlus