Resting Energy Expenditure and Body Composition in Bedridden Institutionalized Elderly Women With Advanced-Stage Pressure Sores

Abstract

Background. Our study investigated nutritional status, body composition, and resting energy expenditure (REE) in elderly patients with advanced-stage pressure sores (PS), in addition to researching any hypermetabolic condition and its relationship with PS size.

Clinical validity of the estimated energy requirement and the average protein requirement for nutritional status change and wound healing in older patients with pressure ulcers: A multicenter prospective cohort study

“…After 3 weeks, nutritional marker levels had decreased in patients receiving less than the requirement, but were stable or increased in patients receiving more. Past studies have evaluated the effect of nutritional intake on wound healing, but the effects on nutritional status markers in patients with PrU, whose metabolic conditions are altered by the damage of PrU, remain controversial . One reason for the conflicting results could be the narrow range of dietary intake at relatively high levels even of the control groups, masking differences in nutritional change between groups .…”

“…Nutritional requirements are generally determined based on the level at which metabolic balance is maintained, considering probability of deficiency . Maintaining metabolic balance is of particular importance for patients with PrU, because the condition itself causes increased catabolism . The current recommendations in PrU guidelines, however, are extrapolated from clinical trials that evaluated the effect of oral nutritional supplements in promoting wound healing, but that less clearly evaluated changes in nutritional status .…”

Escarres : comment accélérer la cicatrisation ?

“…La deuxième étude conduite chez 52 femmes âgées grabataires institutionnalisées montre que la DER des patientes avec escarres de stade 3 et 4 (perte de substance comprenant le derme, le muscle et jusqu'à l'os) était de 26 kcal/kg par jour, contre 21 kcal/kg par jour chez les patientes sans escarres. Avec l'application de facteur de correction de 1,26 à 1,5, les besoins énergétiques estimés sont de 33 à 39 kcal/kg par jour [13].…”

Estimating Energy Needs in Nutrition Support Patients

“…A further difficulty is that many of the suggested stress factors were developed at a time when it was common to adjust the body weight used in the Harris‐Benedict equation if the patient population was obese. Most research into the resting metabolic rate of acutely ill, non–intensive care unit (ICU) patients indicates that metabolic rate is elevated by about 10% on average, but many studies show the elevation to be higher than 10%, and all conclude that there is considerable individual variability 5 . ‐ 8 , 37 ‐ 39 This variability may largely invalidate the stress modifier approach to assessing resting metabolic rate in individuals.…”