Evaluation of an in vivo prompt gamma neutron activation facility for body composition studies in critically ill intensive care patients: results on 41 normals. 1984

A H Beddoe, and S J Streat, and G L Hill

A programme of metabolic and nutritional research is being undertaken in critically ill patients requiring intensive care. Central to this research is the measurement of the three nutritionally important compartments of body composition, protein, fat, and water by a combination of tritium dilution and prompt gamma in vivo neutron activation analysis (IVNAA). In this paper a calibration technique is presented that enables absolute estimates of total body nitrogen (TBN) to be made using prompt gamma IVNAA in critically ill patients with gross abnormalities in body composition, especially in their state of hydration. This technique, which is independent of skinfold anthropometry and does not make a priori assumptions about the ratios of major body compartments, has been applied to 41 normal volunteers and the derived values for nitrogen compared with values obtained by applying three currently used calibration methods to the same experimental data; the other methods are used at centers which also measure nitrogen by prompt gamma IVNAA. Close agreement is obtained between the four calibration methods, with correlation coefficients relative to the Auckland technique of 0.999, 0.998, and 0.994. In addition, the measured values of TBN are compared to values obtained for the same group of volunteers using sets of empirical equations from two centers, one of which uses prompt gamma IVNAA (Brookhaven National Laboratory, Long Island, USA) and the other delayed gamma IVNAA (Leeds, Britain). The empirical equations relate TBN in normal people to age, height, weight and sex. The mean ratios of experimental to predicted TBN (with SEMs) are 1.013 +/- 0.017 and 1.002 +/- 0.014, respectively. Mean values of the ratio of TBN to fat-free mass (0.0340 +/- 0.0004) and of total body water to fat-free mass (0.716 +/- 0.002) agree closely with values reported elsewhere for normals by a variety of techniques including chemical analysis. Finally, TBN results based on the four different calibration methods are presented for five surgical patients, demonstrating the importance of the calibration method on estimates of TBN in patients with abnormal body composition. It is concluded that this technique will provide accurate estimates of the total body content of protein, water, and fat in intensive care patients.

UI MeSH Term Description Entries
D008297 Male Males
D008433 Mathematics The deductive study of shape, quantity, and dependence. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Mathematic
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D008903 Minerals Native, inorganic or fossilized organic substances having a definite chemical composition and formed by inorganic reactions. They may occur as individual crystals or may be disseminated in some other mineral or rock. (Grant & Hackh's Chemical Dictionary, 5th ed; McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Mineral
D009501 Neutron Activation Analysis Activation analysis in which the specimen is bombarded with neutrons. Identification is made by measuring the resulting radioisotopes. (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Activation Analysis, Neutron,Analysis, Neutron Activation,Activation Analyses, Neutron,Analyses, Neutron Activation,Neutron Activation Analyses
D009584 Nitrogen An element with the atomic symbol N, atomic number 7, and atomic weight [14.00643; 14.00728]. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells.
D011506 Proteins Linear POLYPEPTIDES that are synthesized on RIBOSOMES and may be further modified, crosslinked, cleaved, or assembled into complex proteins with several subunits. The specific sequence of AMINO ACIDS determines the shape the polypeptide will take, during PROTEIN FOLDING, and the function of the protein. Gene Products, Protein,Gene Proteins,Protein,Protein Gene Products,Proteins, Gene
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D001823 Body Composition The relative amounts of various components in the body, such as percentage of body fat. Body Compositions,Composition, Body,Compositions, Body
D001834 Body Water Fluids composed mainly of water found within the body. Water, Body

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