RT Journal
A1 LONG CL
T1 ARe estimating energy expenditures in hospitalized patients appropriate?
JF Archives of Surgery
JO Archives of Surgery
YR 1989
FD December 1
VO 124
IS 12
SP 1464
OP 1465
DO 10.1001/archsurg.1989.01410120114025
UL http://dx.doi.org/10.1001/archsurg.1989.01410120114025
AB To the Editor.—In the article by Cortes and Nelson1 that appeared in the March 1989 issue of the Archives, the authors presented data to suggest that they have detected errors in the estimation of energy expenditures in patients in a surgical intensive care unit. While this may be true, there are some concerns that need to be addressed in their protocol.First, they evaluated 29 patients attached to mechanical ventilatory support while receiving central parenteral nutrition. The effect of the ventilator on energy expenditure is not discussed. The effect of central parenteral nutrition on the measured expenditure in the surgical patient not attached to a ventilator is also not discussed. They should not use this limited heterogeneous patient population to criticize other data that have been presented to show increases in specific groups of patients.2The second concern is the definition of the stress factor. If the