Critical care medicine · 1992
Metabolic requirements in tetanus.
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Linton D M, Wells Y, Potgieter P D
Аннотация
OBJECTIVE: To measure the metabolic requirements of patients with severe tetanus who require mechanical ventilation.
DESIGN: Prospective, consecutive, open study using routine monitoring.
SETTING: A multidisciplinary ICU in a large teaching hospital.
PATIENTS: Five consecutive patients (age range 30 to 54 yrs) with severe tetanus. Four patients had clinical evidence of sympathetic nervous system overactivity.
INTERVENTIONS: All patients were mechanically ventilated and appropriately treated for severe tetanus. Sympathetic nervous system overactivity was reduced by the administration of sedatives.
MEASUREMENTS AND MAIN RESULTS: Measurements of metabolic rates were made using an indirect calorimetry device. Each of the five patients had three 8-hr periods of continuous metabolic monitoring for each of three levels of daily enteral nutritional support. The measured metabolic rates varied from 1310 to 2050 kcal/24 hrs (predicted 1280 to 1770 kcal/24 hrs). The variations from predicted basal metabolic rates varied from -6.3% to +10.5%.
CONCLUSIONS: The measured metabolic rates of patients with severe tetanus who are appropriately sedated are relatively constant and are within 10.5% of the predicted basal metabolic rates.
DESIGN: Prospective, consecutive, open study using routine monitoring.
SETTING: A multidisciplinary ICU in a large teaching hospital.
PATIENTS: Five consecutive patients (age range 30 to 54 yrs) with severe tetanus. Four patients had clinical evidence of sympathetic nervous system overactivity.
INTERVENTIONS: All patients were mechanically ventilated and appropriately treated for severe tetanus. Sympathetic nervous system overactivity was reduced by the administration of sedatives.
MEASUREMENTS AND MAIN RESULTS: Measurements of metabolic rates were made using an indirect calorimetry device. Each of the five patients had three 8-hr periods of continuous metabolic monitoring for each of three levels of daily enteral nutritional support. The measured metabolic rates varied from 1310 to 2050 kcal/24 hrs (predicted 1280 to 1770 kcal/24 hrs). The variations from predicted basal metabolic rates varied from -6.3% to +10.5%.
CONCLUSIONS: The measured metabolic rates of patients with severe tetanus who are appropriately sedated are relatively constant and are within 10.5% of the predicted basal metabolic rates.