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Resting energy expenditure and respiratory quotient in adolescents following spinal fusion surgery.

Abstract：

STUDY DESIGN:Prospective, 2-factor design. The first factor was the group with 2 levels, spine surgery and control. The second factor was timing with 3 levels, baseline, 1-week follow-up, and 6-week follow-up. OBJECTIVES:The purpose of this study was to assess changes in caloric requirements and the body's nutritional substrate utilization following spinal surgery in adolescents. SUMMARY OF BACKGROUND DATA:In an effort to optimize recovery from and assure best possible outcomes after spinal surgery in adolescents, the nutritional requirements of spine surgery patients were evaluated. METHODS:Indirect calorimetry was used to measure resting energy expenditure, a measure of caloric requirements, and respiratory quotient, an indication of percentages of fat, protein, and carbohydrate utilization. Twenty-three patients undergoing spinal fusion surgery were evaluated immediately before surgery, at an average of 4.8 days after surgery, and at an average 53 days follow-up. A control group of 15 patients completed the same series of 3 tests: baseline, 1-week later, and 6-weeks later. RESULTS:Resting energy expenditure increased significantly by 150 kcal/day (2.7 kcal/kg/day) following spinal fusion surgery in adolescents. By 6 weeks postoperation, patient's caloric requirements returned to baseline level. No changes in resting energy expenditure occurred in the control group between the 3 test periods. Anterior/posterior surgeries and single surgeries had similar kcal/kg/day requirements after surgery. Respiratory quotient decreased significantly following surgery (0.79 to 0.70), indicating a shift to fat oxidation after surgery. At 6 weeks postoperation, the respiratory quotient returned to baseline level. The control group demonstrated no change in the respiratory quotient during the 3 testing periods. CONCLUSIONS:Substrate utilization shifts to fat oxidation in adolescents following spinal surgery, indicating lipids would be the alimentation of choice immediately after surgery. Caloric requirements increase 9% above the baseline measurements. Anterior/posterior surgeries and single surgeries (anterior or posterior alone) have the same increase in kcal/kg/day. Because of the substrate utilization change by the body after surgery, a preponderance of these calories should initially be given as lipids. After approximately 6 weeks, both resting energy expenditure and respiratory quotient returned to preoperative levels following spinal surgery in adolescents, indicating special nutrition is not required beyond 6 weeks.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

McMulkin ML,Ferguson RL

doi

10.1097/01.brs.0000134564.24874.10

keywords:

subject

Has Abstract

pub_date

2004-08-15 00:00:00

pages

1831-5

issue

eissn

0362-2436

issn

1528-1159

pii

00007632-200408150-00020

journal_volume

pub_type

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Resting energy expenditure and respiratory quotient in adolescents following spinal fusion surgery.