P622 - INDIRECT CALORIMETRY AS A TOOL TO ESTIMATE ANABOLIC GLUCOSE METABOLISM DURING NUTRITIONAL SUPPORT IN PATIENTS WITH ABDOMINAL CATASTROPHES

P622

INDIRECT CALORIMETRY AS A TOOL TO ESTIMATE ANABOLIC GLUCOSE METABOLISM DURING NUTRITIONAL SUPPORT IN PATIENTS WITH ABDOMINAL CATASTROPHES

O. Sobotka^1,2,*, P. Skorepa^1,2,3, J. Visek^1,2, L. Sobotka^1,2

¹3rd Department of Internal Medicine-Metabolism and Gerontology, Faculty of Medicine in Hradec Kralove, Charles University, ²3rd Department of Internal Medicine-Metabolism and Gerontology, University Hospital Hradec Kralove, ³Department of Military Internal Medicine and Military Hygiene, University of Defence, Military Faculty of Medicine, Hradec Kralove, Czech Republic

Rationale: An anabolic state is essential for increasing body cell mass and promoting wound healing in malnourished patients with abdominal catastrophes. This state is typically characterized by a respiratory quotient (RQ) greater than the food quotient (FQ), which is derived from the composition of administered nutrients. Thus, RQ monitoring during nutritional support may offer clinically relevant insights in comparison to the resting energy expenditure (REE) alone. This study evaluated the effect of nutritional support on RQ in this patient population.

Methods: Eighteen patients receiving parenteral or enteral nutrition aimed at achieving a positive energy balance were included. Energy expenditure and RQ were measured at regular intervals using the Q-NRG metabolic monitor (COSMED, Rome, Italy). The relationship between RQ and the intake of carbohydrates (CHO) and lipids was analyzed.

Results: Carbohydrate intake significantly influenced RQ (R² = 0.334), while lipid intake showed no such effect. Although the overall energy balance was positive (median 221.4 kcal/day; Q1–Q3: 79.9–811.7 kcal/day), there was considerable inter-individual variability. The anabolic (non-oxidized) portion of CHO intake was also positive (median 82.9 g/day; Q1–Q3: 0.4–147.3 g/day) but varied substantially among patients. The association between CHO intake and RQ was dependent on the individual’s clinical status.

Conclusion: Regular measurement of RQ and REE, in conjunction with calculated FQ, can guide individualized recommendations for carbohydrate and fat intake in patients with abdominal catastrophes. Due to significant variability in metabolic response, individualized and frequent monitoring is essential for optimizing nutritional support.

Disclosure of Interest: None declared