Evaluating the effects of continuous veno-venous hemodiafiltration on O2 and CO2 removal and energy expenditure measurement using indirect calorimetry

被引:0
作者
Wasyluk, Weronika [1 ]
Fiut, Robert [2 ]
Czop, Marcin [3 ]
Zwolak, Agnieszka [1 ]
Dabrowski, Wojciech [4 ]
Malbrain, Manu L. N. G. [4 ,5 ,6 ]
Jonckheer, Joop [7 ]
机构
[1] Med Univ Lublin, Dept Internal Med & Internal Med Nursing, Lublin, Poland
[2] Med Univ Lublin, Dept Clin Physiotherapy, Lublin, Poland
[3] Med Univ Lublin, Dept Clin Genet, Lublin, Poland
[4] Med Univ Lublin, Dept Anaesthesiol & Intens Therapy 1, Lublin, Poland
[5] Med Data Management, Medaman, Geel, Belgium
[6] Int Fluid Acad, Lovenjoel, Belgium
[7] Vrije Univ Brussel VUB, Univ Ziekenhuis Brussel UZ Brussel, Dept Intens Care Med, Brussels, Belgium
来源
ANNALS OF INTENSIVE CARE | 2025年 / 15卷 / 01期
关键词
Oxygen; Carbon dioxide; Indirect calorimetry; Resting energy expenditure; Respiratory quotient; Sepsis; Continuous renal replacement therapy; CRRT;
D O I
10.1186/s13613-025-01426-2
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background Continuous veno-venous hemodiafiltration (CVVHDF) is used in critically ill patients, but its impact on O-2 and CO2 removal, as well as the accuracy of resting energy expenditure (REE) measurement using indirect calorimetry (IC) remains unclear. This study aims to evaluate the effects of CVVHDF on O-2 and CO2 removal and the accuracy of REE measurement using IC in patients undergoing continuous renal replacement therapy. Design Prospective, observational, single-center study. Methodology Patients with sepsis undergoing CVVHDF had CO2 flow (QCO(2)) and O-2 flow (QO(2)) measured at multiple sampling points before and after the filter. REE was calculated using the Weir equation based on VCO2 and VO2 measured by IC, using true VCO2 accounting for the CRRT balance, and estimated using the Harris-Benedict equation. The respiratory quotient (RQ), the ratio of VCO2 to VO2, was evaluated by comparing measured and true values. Results The mean QCO(2) levels measured upstream of the filter were 76.26 +/- 17.33 ml/min and significantly decreased to 62.12 +/- 13.64 ml/min downstream of the filter (p < 0.0001). The mean QO(2) levels remained relatively unchanged. The mean true REE was 1774.28 +/- 438.20 kcal/day, significantly different from both the measured REE of 1758.59 +/- 434.06 kcal/day (p = 0.0029) and the estimated REE of 1619.36 +/- 295.46 kcal/day (p = 0.0475). The mean measured RQ value was 0.693 +/- 0.118, while the mean true RQ value was 0.731 +/- 0.121, with a significant difference (p < 0.0001). Conclusions CVVHDF may significantly alter QCO(2) levels without affecting QO(2), influencing the REE and RQ results measured by IC. However, the impact on REE is not clinically significant, and the REE value obtained via IC is closer to the true REE than that estimated using the Harris-Benedict equation. Further studies are recommended to confirm these findings.
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页数:10
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