Resting energy expenditure in end-stage cystic fibrosis patients before and after lung transplantation
F.M Hollander, A. Kok, N.M. de Roos, G. Belle-van Meerkerk, E.A. van de Graaf
Chair(s): dr. Dennis A. Hesselink, internist-nefroloog, Erasmus MC & dr. Marieke Roemeling, internist i.o., UMC Groningen
Wednesday 9 march 2016
16:40 - 16:50h
at Zaal 1 & 2
Categories: Parallelsessie (klinisch)
Parallel session: Parallelsessie V - Klinisch
Background & aims:
Resting energy expenditure (REE) is increased in patients with cystic fibrosis (CF) with end-stage lung disease due to chronic inflammation and pulmonary infections. It is expected that energy expenditure will be lower after lung transplantation (LTx) because the inflammation will decrease. We therefore assessed REE in pre-LTx CF and post-LTx CF patients. We also studied the agreement between measured and predicted REE.
Methods:
Included were 12 pre-LTx CF patients (9 women, median age 31.6 years IQR 23.3-40.0) and 12 post-LTx CF patients (6 women, median age 33.5 years, IQR 22.3-40.3). REE was measured in a fasted state using indirect calorimetry. Values were compared with predicted REE calculated by formulas of Harris Benedict (HB 1919 and 1984), Schofield and World Health Organization (WHO) 1985. A calculated REE between 90% and 110% of REE measured was considered adequate.
Results:
Mean REE measured by indirect calorimetry was 1735 kcal (SD 251) pre-LTx and 1650 kcal (SD 235) post-LTx (p=0.40). REE expressed per kg Fat Free Mass (FFM) was 40.5 kcal/kg in pre-LTx CF patients, which was about 15% higher than the 34.3 kcal/kg in post-LTx CF patients (p=0.01). Prediction equations underestimate REE in at least 75% of pre-LTx and 33% of post-LTx CF patients. The predicted REE using the four different prediction formulas did not differ significant from each other. REE expressed per kg Fat Free Mass (FFM) was 40.5 kcal/kg in pre-LTx CF patients, which was about 15% higher than the 34.3 kcal/kg in post-LTx CF patients (p=0.01).
Conclusions:
After lung transplantation the REE per kg FFM is decreased in patients with CF. Prediction equations underestimate REE in end-stage CF patients. REE per kg FFM is lower post-LTx than pre-LTx in CF patients. Measurement of REE is recommended for LTx CF patients, especially pre-LTx to optimize energy requirements for improving the nutritional status.
