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Karger Publishers, Annals of Nutrition and Metabolism, 4(66), p. 188-195, 2015

DOI: 10.1159/000430848

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Hypermetabolism in the Initial Phase of Intensive Care Is Related to a Poor Outcome in Severe Sepsis Patients

Journal article published in 2015 by Chao Wu, Xinying Wang, Wenkui Yu, Feng Tian, Sitong Liu, Pei Li, Jieshou Li, Ning Li
This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

<b><i>Objective:</i></b> To assess the incidence of hypermetabolism, defined as high resting energy expenditure, in severe sepsis ICU patients, and evaluate the suitability of excessive resting energy expenditure (REE) as a risk factor of their clinical outcome. <b><i>Methods:</i></b> In a single-center, prospective, six-month observational study in China, the measured REE (MREE) was estimated daily using indirect calorimetry (IC) for the first 5 days of ICU admission. The predicted REE (PREE) was determined using the Harris-Benedict equation. ICU severity criteria (APACHE II and SOFA scores), baseline and health characteristics, and laboratory test results, were compared between the hyper-metabolic (MREE/PREE ratio ≥1.3) and the normometabolic (MREE/PREE ratio <1.3) groups, and between the survivor and non-survivor groups, classified according to 28-day mortality. <b><i>Results:</i></b> Of the 62 included ICU patients (age, 57.1 ± 19.5 years), 34 patients (55%) were hypermetabolic. The 28-day mortality rate in the hypermetabolic and normometabolic groups was 35 and 18%, respectively (p < 0.001). The MREE/PREE ratio and C-reactive protein (CRP) plasma concentration were significantly higher in non-survivors than survivors (p = 0.017), and were significantly (p < 0.05) associated with 28-day mortality (OR<sub>MREE/ PREE</sub> = 1.018, 95% CI, 1.010-2.544, p = 0.031 and OR<sub>CRP</sub> = 1.010, 95% CI, 1.005-2.173, p = 0.025, respectively). <b><i>Conclusion:</i></b> In critical sepsis patients admitted to ICU, the MREE/PREE ratio may be a valuable evaluation index of the clinical outcome.