Energy expenditure and nutritional adequacy of rehabilitation paraplegics with asymptomatic bacteriuria and pressure sores

Objective: To measure resting energy expenditure (REE) in a group of people with postacute paraplegia, quantify the impact of asymptomatic bacteriuria and pressure sore(s) on patients' metabolic rate, and estimate the adequac y of patients' nutritional intakes to preserve patients' protein levels. Material and methods: Ten males with post-acute paraplegia aged 42.1 +/- 18 .7 years. We evaluated: height, body mass index (BMI), resting energy expen diture (REE), total daily calorie requirement (((E) over dot)), 24-h urine creatinine excretion (Cru), creatinine index (CI), and nitrogen balance (NB ). Results: Subjects with paraplegia showed high erythrocyte sedimentation rat es. As a group, they had normal resting calorie consumption when REE was no rmalized for unit of urine creatinine (REE/Cru), it was higher in patients than in controls. Six of the 10 patients had a low calorie intake: of these only three had a negative nitrogen balance. Conclusion: In conclusion, the resting energy expenditure of the subjects w ith significant bacteriuria and pressure sore(s) of 23.7 kcal/kg/day sugges ts that a large portion of patients may have an inadequate calorie protein intake to preserve their nutritional status. The clinical significance of t his study is that 28.5 kcal/kg/day may be the lower calorie threshold to me et the metabolic demands of people with apyretic paraplegia with bacteriuri a and pressure sore(s).