A case report of nutritional therapy guided by metabolic cart monitoring in a patient with extracorporeal membrane oxygenation
Abstract
Patients supported by extracorporeal membrane oxygenation (ECMO) are often in a state of severe hypermetabolism and hypercatabolism, making nutritional support difficult, and there are significant deviations in estimating energy consumption by traditional formulas. On May 1, 2025, a 42-year-old male patient with acute extensive anterior myocardial infarction was admitted to the First Dongguan Affiliated Hospital of Guangdong Medical University. After admission, the patient underwent coronary stent implantation, and subsequently developed severe complications such as cardiac failure, cardiogenic shock and electrical storm, with an Acute Physiology and Chronic Health Evaluation II of 34 points. A series of invasive supportive treatments were successively administered to the patient, including tracheal intubation with mechanical ventilation, intra-aortic balloon pump (IABP), veno-arterial ECMO (VA-ECMO), continuous renal replacement therapy (CRRT) and cardiac pacemaker implantation. During the treatment, resting energy expenditure (REE) of the patient was monitored in real time by metabolic cart (indirect calorimetry), and the monitoring results were compared with those calculated by the traditional Harris-Benedict formula. Individualized nutritional support regimens were formulated based on the metabolic cart monitoring data: the ratio of enteral to parenteral nutrition was 1 : 2 during VA-ECMO treatment, and adjusted to 2 : 1 in the late post-weaning period with the addition…
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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