Liver Resection Clinical Trial
Official title:
The Effect of Liver Regeneration on Resting Energy Expenditure After Liver Resectional Surgery
This observational study will measure resting energy expenditure in patients who have undergone liver resection and compare methods of measuring resting energy expenditure.
Penetrating liver injury occurs commonly in victims of battlefield trauma. It is associated
with a high mortality and morbidity rate. Management of liver injury is complex and
challenging and can often involve debridement or anatomical resection of liver tissue.
Following liver resection, the liver regenerates to its original volume. Liver regeneration
involves complex metabolic processes and maximal regeneration occurs over the first post
operative week. This process is highly energy dependent and adds a further burden on post
operative energy and therefore nutritional requirements.
Inadequate post-operative nutrition is associated with poorer outcomes and complication
rates. Additionally, over feeding is also associated with adverse outcome. The actual
additional energy expenditure involved in liver regeneration is not currently known and
therefore accurate calorific balance remains a challenge.
The measurement of energy expenditure in these patients is therefore important.
Traditionally energy expenditure has been measured by indirect calorimetry and doubly
labelled water. These techniques require skilled operators and are often impractical for
everyday clinical usage and impossible in the deployed setting.
A recent development is a lightweight armband that measures total and resting energy
expenditure. It has been validated against the gold standard techniques in various settings
including cancer cachexia, obesity and healthy volunteers and is deemed highly acceptable
also. It has not been validated in the unique setting of liver regeneration.
Therefore this study will assess the energy expenditure in patients undergoing liver
regeneration and attempt to validate a new minimally invasive device against the traditional
measurements of energy expenditure.
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Observational Model: Case Control, Time Perspective: Prospective
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