Energy demand in patients with stroke who are sedated and receiving mechanical ventilation

Object. The purpose of this study was 1) to determine the total energy expenditure (TEE) in patients with acute stroke who are sedated and receiving mechanical ventilation; and 2) to compare the TEE between patients with ischemic and hemorrhagic stroke. Methods. Thirty-four consecutive nonseptic patients with stroke requiring sedation and mechanical ventilation were prospectively examined; 13 of the patients had experienced spontaneous intracerebral hemorrhage and 21 cerebral ischemia of the middle cerebral artery territory. The TEE was evaluated using continuous indirect calorimetry during the first 5 days after admission to the intensive care unit. The serum albumin concentration was determined on admission and on Day 5. The TEE varied from 1560 +/- 240 to 1623 +/- 251 kcal/day. A highly significant correlation between the TEE and the basal energy expenditure (BEE), as predicted using the Harris-Benedict equation, was observed in both groups. No significant differences in the TEE were detected between the two groups or among the different study days. Conclusions. A highly significant correlation was found between the TEE and the predicted BEE in patients with acute stroke who have been sedated and have received mechanical ventilation. No significant differences were observed between patients with hemorrhagic and ischemic stroke. Further studies are needed to evaluate the effect of tailored feeding on clinical outcome in these patients.