No abstract

Our purpose in this study was to examine whole body composition, using dual energy x-ray absorptiometry (DEXA) during dietary intervention in preterm infants (< or = 1750 g birthweight, < or = 34 wk gestation). At discharge, infants were randomized to be fed either a preterm infant formula (discharge-6 mo; group A) or a term formula (discharge-6 mo; group B), or the preterm formula (discharge-term) and the term formula (term-6 mo; group C). Nutrient intake was measured between each clinic visit. To measure body composition, DEXA was used at discharge, term, 12 wk, 6 mo, and 12 mo corrected age. The data were analyzed by ANOVA. At discharge, no differences were noted in patient characteristics between groups A, B, and C. Although energy intakes were similar, protein and mineral intakes differed between groups (A > C > B; p < 0.0001). During the study, weight gain and LM gain were greater in group A than B. At 12 mo, weight, LM, FM, and BMM but not % FM or BMD were greater in group A than B. However, the effects of diet were confined to boys, with no lasting effects seen in girls. In summary, therefore, DEXA was precise enough to detect differences in whole body composition during dietary intervention. Increased weight gain primarily reflected an increase in LM and is consistent with the idea that the preterm formula more closely met protein and/or protein-energy needs in rapidly growing preterm male infants.

No abstract

Background-Existing guidelines for optimal positioning of endotracheal tubes in neonates are based on scanty data and relate to measurements that are either non-linear or poorly reproducible in sick infants. Foot length can be measured simply and rapidly and is related to a number of external body measurements. Objectives-To evaluate the relation of foot length to nasotracheal length in direct measurements at post mortem examinations, and then compare its clinical relevance with traditional weight based estimates in a randomised controlled trial. Methods-The dimensions of the upper airway were measured at autopsy in 39 infants with median (range) postmenstrual age and birth weight of 32 (24-43) weeks and 1630 (640-3530) g. The regression equations with 95% prediction intervals were calculated to estimate the optimal nasotracheal length from foot length. In a randomised trial, 59 neonates were nasally intubated according to foot length and body weight based estimates to assess the achievement of "optimal" and "satisfactory" tube placements. Results-In the direct measurements of the airway at autopsy, foot length was a better predictor of nasotracheal distances (r 2 = 0.79) than body weight, gestational age, and head circumference (r 2 = 0.67, 0.58, and 0.60 respectively). Measurement of foot length was easy and highly reproducible. In the randomised controlled trial, there were no significant diVerences between the foot length and body weight based estimates in the rates of optimal (44% v 56%) and satisfactory (83% v 72%) endotracheal tube placements. Conclusions-Foot length is a reliable and reproducible predictor of nasotracheal tube length and is at least as accurate as the conventional weight based estimation. This method may be particularly valuable in sick unstable infants. (Arch Dis Child Fetal Neonatal Ed 2001;85:F60-F64)