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Determination of the Stress Factor Calculated from the Changes in the Measured Resting Energy Expenditure with Indirect Calorimetry in Patients Undergoing Pancreaticoduodenectomy
췌십이지장절제술 환자의 간접열량측정기로 측정한 휴식대사량 변화를 이용한 스트레스 계수의 산정
J Clin Nutr 2017;9:62-67
Published online December 31, 2017
© 2017 Korean Society for Parenteral and Enteral Nutrition.

Seon Hyeong Kim1,2, Baik Hwan Cho1,3, Sook Bae Kim2, Mi Jin Jeong1, Hee Chul Yu1,3
김선형1,2, 조백환1,3, 김숙배2, 정미진1, 유희철1,3

1Nutrition Support Team, Chonbuk National University Hospital, 2Department of Food Science and Human Nutrition, Chonbuk National University, 3Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea
1전북대학교병원 영양집중지원팀, 2전북대학교 식품영양학과, 3전북대학교 의학전문대학원 외과학교실
Hee Chul Yu
Department of Surgery, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea
Tel: +82-63-250-1604, Fax: +82-63-250-1604, E-mail:
Received June 13, 2017; Revised August 23, 2017; Accepted September 27, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: To predict the energy expenditure using the stress factor representing the ratio of the metabolic variation between pre-operation and post-operation in a pancreaticoduodenectomy (PD).
Methods: This was a prospective study conducted on 17 patients (11 males and 6 females) who underwent PD at Chonbuk National University Hospital between March 2010 and October 2011. The rest energy expenditure was measured by indirect calorimetry 1 day before and 3 days after surgery. The height, weight, and fat free mass were also measured 1 day before surgery.
Results: The mean measured rest energy expenditure 1 day before PD (mREEpre) and 3 days after PD (mREEpost) were significantly different (16.8±2.6 vs. 18.8±3.5 kcal/kg/d, P=0.0076). The stress factor, representing the ratio of the metabolic changes between pre- and post-PD, was 1.12±0.17. The recommended energy requirement for PD patients is estimated to be 23∼24 kcal/ideal body weight/d [determined from the measured preoperative rest energy expenditure (16.8±2.6 kcal/kg/d)×activity factor (1.2∼1.3)×stress factor (1.12)].
Conclusion: PD patients maintained a hypermetabolic status and the applicable stress factor was 1.12.
Keywords : Indirect calorimetry, Pancreaticoduodenectomy, Stress factor, Rest energy expenditure


December 2017, 9 (2)