Indirect calorimetry for nutritional support and estimating stress factor during treatment of bronchopleural fistula: Three case reports

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  • Kitaoka Shuta
    Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Division of Thoracic Surgery, Department of Surgery, Saiseikai Shiga Hospital
  • Okada Satoru
    Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
  • Ishihara Shunta
    Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
  • Shimomura Masanori
    Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
  • Kato Daishiro
    Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Division of Thoracic Surgery, Department of Surgery, Saiseikai Shiga Hospital
  • Inoue Masayoshi
    Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine

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  • 間接熱量測定法を用い気管支断端瘻治療中の栄養療法で推定ストレス係数を測定できた3例

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Abstract

<p>Estimation of resting energy expenditure using indirect calorimetry is the most recommended method for determining energy dosage in nutritional management. In addition, the stress factor estimated by comparison with the basal metabolic rate derived from the Harris-Benedict equation can be used to understand the pathophysiology of disease. We performed indirect calorimetry in three patients with bronchopleural fistula after lung cancer surgery (two patients underwent open-window thoracotomy followed by two-stage radical surgery, and one patient underwent one-stage radical surgery), and were able to objectively establish the amount of energy required for treatment. The estimated stress factor was 1.5 (corresponding to moderate infection or higher) in the acute phase, and 1.2-1.6 in the chronic phase when the inflammation had subsided after open window thoracotomy. There have been no reports on the stress factor for severe complications such as bronchopleural fistula or the status after open window thoracotomy: therefore, the estimated stress factors in our case series could be useful for nutritional therapy in cases where indirect calorimetry is not available.</p>

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