USE OF INDIRECT CALORIMETRY TO PREDICT SEPSIS IN A CRITICALLY ILL SAMPLE (RESTING ENERGY EXPENDITURE).
Contributors: Rush University, College Of Nursing.
Published: 1993
Number of pages: 165
Subjects: Health Sciences, Nursing.; Health Sciences, Nutrition.; Health Sciences, Medicine and Surgery.
Description: Sepsis is a significant problem in the United States today, affecting 400,000 people; it has a 40% mortality rate and costs approximately $5--\$10 billion. Early diagnosis is essential for appropriate treatment. Resting energy expenditure (REE) measures done with indirect calorimetry were studied to see if there was a trend in REE values in septic patients (versus a matched nonseptic group) and if there were significant increases before sepsis develops. The sample was 26 (10 septic and 16 nonseptic) medical ICU patients, and the setting was a university hospital in a large metropolitan area. The MediScope, an open-system metabolic cart, was used to measure REE values, and the APACHE III tool was used to compare severity of illness in the control and septic groups. Bone's (1992) criteria for sepsis (plus physician diagnosis) were used to define sepsis. Using repeated measures ANOVA, the septic group did have significantly higher REE values on days 1 and 2 (day before sepsis developed and day of sepsis). However, multivariate trend analysis, looking for linear and polynomial trends, was nonsignificant for any pattern in REE between groups and within the septic group. The study also showed that these patients were fed significantly less (p $<$.005) than the predicted or measured REE. Neither movement nor medications affected the results significantly, meaning if the procedure is controlled, collecting reliable REE data in an ICU is possible. Also, though the septics' temperatures were not significantly different from the nonseptics and there were no significant serial patterns, the septics had a much larger range and variance of temperature than did the nonseptics.
Notes: Source: Dissertation Abstracts International, Volume: 54-04, Section: B, page: 1894.

Thesis (D.N.SC.)--RUSH UNIVERSITY, COLLEGE OF NURSING, 1993.

School code: 0591.