Energy expenditure measured using indirect calorimeter after minimally invasive esophagectomy in ventilated postoperative patients.

Abstract

Minimally invasive esophagectomy has recently become popular after the laparoscopic technique was developed. However, the postoperative energy expenditure in patients undergoing this procedure has not been evaluated. Therefore, we hypothesized that postoperative resting energy expenditure (REE) following minimally invasive esophagectomy is lower than that estimated using the Harris-Benedict equation. Fifteen patients who underwent esophagectomy by thoracoscopy in the prone position were analyzed. After esophagectomy, an indirect calorimeter measured the energy expenditure during ventilation in the ICU. These values and the estimated basal energy expenditure values were compared using the paired t test. The mean age was 66 ± 10 years and mean duration of ventilator use in the ICU was 697 ± 70 mins. The acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores at the time of ICU admission were 13 ± 4 and 2 ± 1, respectively. The average temperature, heart rate, and respiratory rate during ventilation were 36.2 ± 0.6°C, 67 ± 9 beats/min, and 12 ± 2/min, respectively. The average REE during ventilation was 985 ± 167 kcal/day (18.1 ± 3.4 kcal/kg/day). The estimated REE was 1191 ± 159 kcal/day. The average REE measured using the indirect calorimeter during ventilation was significantly lower than the estimated REE (83 ± 10% of the estimated REE, p<0.001). In conclusion, the REE measured by an indirect calorimeter after minimally invasive esophagectomy at early postoperative stage under sedation was significantly lower than the REE estimated using the Harris-Benedict equation.