Preoperative metabolic status is associated with different evolution of resting energy expenditure after liver transplant in adults
Ana Brito-CostaLuís Pereira‐da‐SilvaAna Luísa PapoilaMarta AlvesÉlia MateusFernando NolascoEduardo Barroso
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Introducción: el gasto energético en reposo (GER) después del trasplante hepático no está totalmenteKeywords:
Resting energy expenditure
Resting energy expenditure
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Resting metabolism plays a critical role in healthy weight management. Metabolic adaptations in response to lifestyle cues induce acclimatization of factors involved in resting state energy homeostasis. PURPOSE: To determine the effects of dietary modification and exercise intensity on resting energy metabolism and body composition in sedentary female cohort. METHODS: Subjects (n=46) with >25% fat mass participated in 10-weeks of 200 kcal·24 h-1 caloric deficit, adherence to whole-foods, plant-based diet, and randomization into three exercise groups. Exercise intensity levels were set by respiratory exchange ratio (RER) ranges determined through submaximal VO2-uptake treadmill test; Low: RER=0.75 (n=16), Moderate: RER=0.85 (n=16), High RER=0.95 (n=14). Resting metabolic rate (RMR) variables—respiratory quotient (RQ), VO2, VCO2, resting energy expenditure (REE), and macronutrient substrate oxidation rates (KCHO, KFAT)—were measured using indirect calorimetry at pre and post treatment stages with whole-body air displacement plethysmography to obtain body composition profiles. One-way ANOVA was performed to evaluate mean changes in resting energy metabolism and body composition. RESULTS: Significant differences in RQ and VCO2 were noted between groups (F 1,46=7.88, p=.001; F 1,46=3.51, p=.039, respectively). Significant differences in KCHO and KFAT substrate oxidation rates were noted between groups likewise (F 1,46=5.74, p=.006; F 1,46=5.05, p=.011, respectively). Changes in total body mass showed significant differences (F 1,46=6.39, p=.004). The most positive improvements in metabolic efficiency variables were appreciated in the low and moderate intensity groups in post hoc analysis. CONCLUSION: The combination of modest caloric adjustment, adherence to plant-based diet, and participating in a low or moderate intensity exercise program confers positive changes in metabolic status and corrective energy homeostasis that promotes effective body composition normalization.
Respiratory quotient
Resting energy expenditure
Respiratory exchange ratio
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Establishing the amount of energy needed to cover the energy demand of children doing sport training and thus ensuring they achieve an even energy balance requires the resting energy expenditure (REE) to be estimated. One of the methods that measures REE is the indirect calorimetry method, which may be influenced by many factors, including body composition, gender, age, height or blood pressure. The aim of the study was to assess the correlation between the resting energy expenditure of children regularly playing football and selected factors that influence the REE in this group. The study was conducted among 219 children aged 9 to 17 using a calorimeter, a device used to assess body composition by the electrical bioimpedance method by means of segment analyzer and a blood pressure monitor. The results of REE obtained by indirect calorimetry were compared with the results calculated using the ready-to-use formula, the Harris Benedict formula. The results showed a significant correlation of girls’ resting energy expenditure with muscle mass and body height, while boys’ resting energy expenditure was correlated with muscle mass and body water content. The value of the REE was significantly higher (p ≤ 0.001) than the value of the basal metabolic rate calculated by means of Harris Benedict formula. The obtained results can be a worthwhile suggestion for specialists dealing with energy demand planning in children, especially among those who are physically active to achieve optimal sporting successes ensuring proper functioning of their body.
Resting energy expenditure
Kilogram
Energetics
Total energy expenditure
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Resting energy expenditure
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Because interstitial lung disease increases the work of breathing, the aim of this study was to determine if this condition is associated with increased energy requirements. A group of 12 clinically stable patients with interstitial lung disease was studied. Patients with a history of weight loss had significantly more severe lung volume restriction. Regression analysis showed that 42% of body weight variation was explained by vital capacity (p < 0.025). Resting energy expenditure was measured by standard methods of indirect calorimetry. The measurements were performed with a ventilated hood during prolonged steady-state periods after an overnight fast. We found that resting energy expenditure was increased to 117.3 and 118.7% of the predicted basal metabolic rate, according to Fleisch and to Harris and Benedict reference values, respectively (p < 0.001). Furthermore, resting energy expenditure was increased to 120.8% of the predicted value according to body fat-free mass (p < 0.001). This extra energy expenditure in patients with interstitial lung disease is similar to that recently reported in patients with chronic obstructive pulmonary disease.
Resting energy expenditure
Basal (medicine)
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Accurate determination of caloric requirements is essential to avoid feeding-associated complications in critically ill patients.In critically ill cancer patients we compared the measured and estimated resting energy expenditures. All patients admitted to the oncology intensive care unit between March 2004 and July 2005 were considered for inclusion. For those patients enrolled (n = 34) we measured resting energy expenditure via indirect calorimetry, and estimated resting energy expenditure in 2 ways: clinically estimated resting energy expenditure; and the Harris-Benedict basal energy expenditure equation.Clinically estimated resting energy expenditure was associated with underfeeding, appropriate feeding, and overfeeding in approximately 15%, 15%, and 71% of the patients, respectively. The Harris-Benedict basal energy expenditure was associated with underfeeding, appropriate feeding, and overfeeding in approximately 29%, 41%, and 29% of the patients, respectively. The mean measured resting energy expenditure (1,623 +/- 384 kcal/d) was similar to the mean Harris-Benedict basal energy expenditure without the addition of stress or activity factors (1,613 +/- 382 kcal/d, P = .87), and both were significantly lower than the mean clinically estimated resting energy expenditure (1,862 +/- 330 kcal/d, P < or = .003 for both). There was a significant correlation only between mean measured resting energy expenditure and mean Harris-Benedict basal energy expenditure (P < .001), but the correlation coefficient between those values was low (r = 0.587).Underfeeding and overfeeding were common in our critically ill cancer patients when resting energy expenditure was estimated rather than measured. Indirect calorimetry is the method of choice for determining caloric need in critically ill cancer patients, but if indirect calorimetry is not available or feasible, the Harris-Benedict equation without added stress and activity factors is more accurate than the clinically estimated resting energy expenditure.
Resting energy expenditure
Caloric theory
Basal (medicine)
Caloric intake
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Objective: The method for measurement of basal metabolic rate (BMR) using indirect calorimetry in adults is well established but is impractical in infants. Methods: In this prospective study energy expenditure was measured using indirect calorimetry in 14 infants when sleeping and when lying quietly awake. Results: Sleeping metabolic rate (SMR) was lower than energy expenditure (EE) measured in the same infants in a quiet resting state (mean difference [SD]: 297 [162] kJ/d; P < 0.005; 55 [33.4] kJ/kg per day; P < 0.005). The correlation within individuals suggests that these differences are related to the level of arousal. Awake EE, but not SMR, was significantly greater than estimated BMR using the FAO/WHO/UNU predictive equation. Conclusions: In infants, the level of arousal during measurement of EE can significantly impact on the interpretation of EE results. A standardized method for the measurement of EE in infants using indirect calorimetry is proposed.
Resting energy expenditure
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Numerous formulas have been used to estimate the calorie requirements of hypermetabolic burned patients. With the recent development of instrumentation for indirect calorimetric measurements, questions have been raised concerning the validity and accuracy of the early equations. Because metabolic rate decreases during the course of wound healing, we attempted to determine the magnitude of hypermetabolism and the accuracy of the Curreri formula in patients with various wound sizes. Twenty-eight patients with a mean initial burn size of 29% body surface area (BSA) had measurements of resting energy expenditure (REE) at regular intervals during their postburn course. Concomitantly, basal energy expenditure (BEE) was calculated from the Harris-Benedict equation; and the predicted energy needs were calculated using the Curreri formula adjusted for current wound size (ACEE). Three significantly different burn size (%BSA) groups were identified: Group 1, 1-10%; Group 2, 11-30%; and Group 3, 31-60% BSA. The measured REE was 27, 35, and 50% greater than the BEE in Groups 1, 2, and 3, respectively (p<0.001). The ACEE underestimated REE by 7% in Group 1, and overestimated REE by 13 and 35% in Groups 2 and 3, respectively (p<0.001). Resting energy expenditure should be measured at regular intervals in individuals with open burn wounds greater than 10% BSA in order to adjust nutritional support appropriately.
Hypermetabolism
Resting energy expenditure
Body surface area
Energy requirement
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Basal rates of whole body protein, glucose, and lipid metabolism and resting energy expenditure (REE) were measured in eight African-American sickle cell disease (SCD) patients and in six African-American controls. Catheters were placed 1) in an antecubital vein for stable isotope infusion and 2) in a heated hand vein for arterialized venous blood. Breath and blood were collected during the last 30 min of the 2.5-h study, and REE was measured by indirect calorimetry. REE [128 ± 5 vs. 111 ± 1 kJ ⋅ kg fat-free mass (FFM) −1 ⋅ day −1 ; P < 0.05 vs. controls] was 15% greater in the SCD patients. Whole body protein breakdown (5.0 ± 0.3 vs. 3.8 ± 0.2 mg ⋅ kg FFM −1 ⋅ min −1 ; P < 0.05 vs. controls) and protein synthesis (4.4 ± 0.3 vs. 3.2 ± 0.2 mg ⋅ kg FFM −1 ⋅ min −1 ; P< 0.05 vs. controls) were 32 and 38% greater, respectively, in the SCD patients, but whole body amino acid oxidation was similar (0.58 ± 0.03 vs. 0.66 ± 0.03 mg ⋅ kg FFM −1 ⋅ min −1 ). Measures of whole body glucose and lipid metabolism were not significantly different between the groups. The additional energy required for the greater rates of whole body protein breakdown and synthesis caused by SCD contributes significantly to the observed increase in REE, suggesting that dietary energy and protein requirements are enhanced in SCD patients.
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The resting metabolic expenditure of seven allogeneic marrow transplant patients supported by total parenteral nutrition was monitored by respiratory indirect calorimetry using a portable apparatus with a plexiglass canopy. The averaged measurements of resting metabolic expenditure using indirect calorimetry were highly correlated with calculated basal energy expenditures, ideal body weights, fat-free weights, and actual body weights. No consistent correlation was demonstrated between resting metabolic expenditure and body temperature. It is concluded that indirect calorimetry using a portable system is feasible and that measurements of energy expenditure so obtained correlate well with calculated estimates employing the basal energy expenditure equation.
Resting energy expenditure
Respiratory quotient
Basal (medicine)
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