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Allometric Prediction of Energy Expenditure in Infants and Children

机译:婴幼儿能量消耗的异速预测

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Predicting energy needs in children is complicated by the wide range of patient sizes, confusing traditional estimation equations, nonobjective stress-activity factors, and so on. These complications promote errors in bedside estimates of nutritional needs by rendering the estimation methods functionally unavailable to bedside clinicians. Here, the authors develop a simple heuristic energy prediction equation that requires only body mass (not height, age, or sex) as input. Expert estimation of energy expenditure suggested a power-law relationship between mass and energy. A similar mass-energy expenditure relationship was derived from published pediatric echocardiographic data using a Monte Carlo model of energy expenditure based on oxygen delivery and consumption. A simplified form of the equation was compared with energy required for normal growth in a cohort of historical patients weighing 2 to 70 kg. All 3 methods demonstrate that variation in energy expenditure in children is dominated by mass and can be estimated by the following equation: Power(kcal/kg/d) = 200 × [Mass(kg)(?0.4)]. This relationship explains 85% of the variability in energy required to maintain expected growth over a broad range of surgical clinical contexts. A simplified power-law equation predicts real-world energy needs for growth in patients over a wide range of body sizes and clinical contexts, providing a more useful bedside tool than traditional estimators.
机译:预测儿童的能量需求的原因是患者人数的范围广泛,传统的估算公式,非客观的压力-活动因素等令人困惑。这些并发症使床旁临床医生无法使用估算方法,从而增加了床边营养需求估算的误差。在这里,作者开发了一个简单的启发式能量预测方程,该方程仅需要体重(而不是身高,年龄或性别)作为输入。能源消耗的专家估计表明,质量与能量之间存在幂律关系。使用基于氧气输送和消耗的能量消耗的蒙特卡洛模型,从已发布的儿科超声心动图数据中得出了相似的质量-能量消耗关系。该方程组的简化形式与一组体重在2至70公斤的历史患者的正常生长所需的能量进行了比较。所有这三种方法都表明,儿童能量消耗的变化主要取决于质量,可以通过以下公式估算:功率(kcal / kg / d)= 200×[质量(kg)(?0.4)]。这种关系解释了在广泛的外科临床环境中维持预期增长所需的能量变异性的85%。简化的幂律方程式可预测现实世界中各种体型和临床情况下患者生长所需的能量,与传统的估算器相比,它提供了一种更有用的床旁工具。

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