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Graphical Calculation of Estimated Energy Expenditure in Burn Patients

Egro FM, Manders EC, Manders EK
University of Pittsburgh Medical Center
2017-01-28

Presenter: Francesco M. Egro

Affidavit:
Vu T. Nguyen

Director Name: Vu T. Nguyen

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction

Introduction
Estimated energy expenditure (EEE) equations overestimate the amount of caloric support necessary for burn patients. Ireton-Jones et al derived two equations, which have proved their reliability but remain challenging to apply given the difficult mathematics involved. This study aims to introduce an accurate graphical calculation of EEE in burn patients that can be easily utilized in the clinical setting.

Methods
The multivariant linear regression analysis from Ireton-Jones et al yielded two equations which were rearranged into the form of a simple linear equation of the type y = mx+b. By choosing an energy expenditure and the age of the subject, the weight was calculated. The endpoints were then calculated and a graph was mapped by means of Adobe FrameMaker.

Results
A graphical representation of Ireton-Jones et al's equations was obtained by plotting the weight (kg) on the y-axis, the age (years) on the x-axis, and a series of parallel lines representing the EEE in burn patients. The EEE has been displayed graphically on a grid to allow rapid determination of the estimated energy expenditure needed for a given patient of a designated weight and age. Two graphs were plotted: one for ventilator-dependent patients and one for spontaneously breathing patients. Correction factors for gender, the presence of additional trauma, and obesity are indicated on the graphical calculators.

Conclusion
We propose a graphical tool to calculate caloric requirements in a easy and portable manner, which can be a useful tool in aiding the burn surgeon to help predict caloric requirements and effectively manage patients with severe traumatic burns.

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