ISSN 1674-3865  CN 21-1569/R
主管：国家卫生和计划生育委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
Chinese Pediatrics of Integrated Traditional and Western Medicine

Chinese Pediatrics of Integrated Traditional and Western Medicine ›› 2021, Vol. 13 ›› Issue (5): 405-408.

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Study on resting energy expenditure of children with sepsis at acute stage

Objective:The mechanism of energy metabolism in critically ill children with sepsis is not clear. The purpose of this study is to make clear the characteristics of energy metabolism in acute phase of sepsis，and to assess the relationship between inflammatory factor and metabolism mode in septic children，and the difference in the mortality rate among different modes.#br# Methods:A total of 178 children with sepsis who were admitted to PICU of Hunan Children's Hospital from December 2017 to June 2019 were prospectively collected as the study subjects. The resting energy expenditure(REE) of the children was measured by indirect calorimetry. The predicted resting energy expenditure(PREE) was calculated with Schofield-HTWT formula. The metabolic mode was decided according to the ratio of REE to PREE. The REE was analyzed in different types of sepsis. The relationship between metabolic mode and inflammatory factors(CRP, PCT and IL-6) was analyzed. The relationship of metabolic mode with mortality was also analyzed.#br# Results:Among 178 children with sepsis， there were 87（49.4%） with hypometabolic pattern，71（39.9%） with normal metabolic pattern，and 19（10.7%） with hypermetabolic pattern(P>0.05). There was no significant difference in REE among different types of sepsis(P>0.05). REE showed no significant difference from predicted values(P>0.05). Only oxygen consumption(VO-2) and carbon dioxide production(VCO-2) were associated with hypometabolic pattern(P<0.001)，while inflammatory factors were not associated with hypometabolic pattern(P>0.05). The mortality rate of the hypometabolic pattern group was higher than other metabolic patterns，，but there was no statistical significance(P>0.05).#br# Conclusion:Most of the children with acute phase of sepsis are with hypometabolic pattern，and inflammatory factors have no significant relationship with metabolism mode; only VO-2 and VCO-2 are related to hypometabolic pattern. There is a significant increase in mortality in children with hypometabolic pattern，due to small number of cases，further study is needed in the future. Therefore, individualized nutrition supply is recommended for critically ill children, and indirect calorimetry is recommended to guide the supply, so as to facilitate the adoption of reasonable nutritional intervention and treatment, in order to improve the prognosis of patients with sepsis.   

  1. Emergency Center，Hunan Children Hospital，Changsha 410007，China
  • Online:2021-10-25 Published:2021-11-18

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Abstract: Objective:The mechanism of energy metabolism in critically ill children with sepsis is not clear. The purpose of this study is to make clear the characteristics of energy metabolism in acute phase of sepsis，and to assess the relationship between inflammatory factor and metabolism mode in septic children，and the difference in the mortality rate among different modes.
Methods:A total of 178 children with sepsis who were admitted to PICU of Hunan Children's Hospital from December 2017 to June 2019 were prospectively collected as the study subjects. The resting energy expenditure(REE) of the children was measured by indirect calorimetry. The predicted resting energy expenditure(PREE) was calculated with Schofield-HTWT formula. The metabolic mode was decided according to the ratio of REE to PREE. The REE was analyzed in different types of sepsis. The relationship between metabolic mode and inflammatory factors(CRP, PCT and IL-6) was analyzed. The relationship of metabolic mode with mortality was also analyzed.
Results:Among 178 children with sepsis， there were 87（49.4%） with hypometabolic pattern，71（39.9%） with normal metabolic pattern，and 19（10.7%） with hypermetabolic pattern(P>0.05). There was no significant difference in REE among different types of sepsis(P>0.05). REE showed no significant difference from predicted values(P>0.05). Only oxygen consumption(VO-2) and carbon dioxide production(VCO-2) were associated with hypometabolic pattern(P<0.001)，while inflammatory factors were not associated with hypometabolic pattern(P>0.05). The mortality rate of the hypometabolic pattern group was higher than other metabolic patterns，，but there was no statistical significance(P>0.05).
Conclusion:Most of the children with acute phase of sepsis are with hypometabolic pattern，and inflammatory factors have no significant relationship with metabolism mode; only VO-2 and VCO-2 are related to hypometabolic pattern. There is a significant increase in mortality in children with hypometabolic pattern，due to small number of cases，further study is needed in the future. Therefore, individualized nutrition supply is recommended for critically ill children, and indirect calorimetry is recommended to guide the supply, so as to facilitate the adoption of reasonable nutritional intervention and treatment, in order to improve the prognosis of patients with sepsis.

Key words: Sepsis, REE, Children