Energy expenditure, growth, and nutritional therapy in appropriate and small for gestational age preterm infants

Abranches, Andrea Dunshee de; Soares, Fernanda Valente Mendes; Villela, Letícia Duarte; Méio, Maria Dalva Barbosa Barker; Zin, Olivia Araújo; Gomes, Saint Clair; Moreira, Maria Elisabeth Lopes

doi:10.1016/j.jped.2017.09.005

Cited by 7 publications

(4 citation statements)

References 19 publications

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“…They showed that, after IC monitoring, the energy requirement was 58 ± 18 kcal/kg/day, which was considerably higher than the calculated EE of 46.6 ± 3 kcal/kg/day (p < 0.05). This study also showed that 59% of the patients were hypermetabolic with a measured EE of >110% than the predicted EE [122]. Howell et al also reported significant differences between the metabolic statuses of infants with congenital diaphragmatic hernias when measuring EE with IC as compared with calculated EE [123].…”

Section: Nutritional Therapy Guided With Indirect Calorimetry In Critsupporting

confidence: 53%

“…In the first two years of life, the nutritional status has a significant impact on the development of all biological and morphological structures. In preterm newborns, it has been observed that the nutritional status has important implications in organ development, especially due to organ immaturity and low nutritional reserve [122]. A high percentage of newborns also have a diaphragmatic hernia.…”

Section: Nutritional Therapy Guided With Indirect Calorimetry In Critmentioning

confidence: 99%

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Assessment of Metabolic and Nutritional Imbalance in Mechanically Ventilated Multiple Trauma Patients: From Molecular to Clinical Outcomes

et al. 2019

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The critically ill polytrauma patient is characterized by a series of metabolic changes induced by inflammation, oxidative stress, sepsis, and primary trauma, as well as associated secondary injuries associated. Metabolic and nutritional dysfunction in the critically ill patient is a complex series of imbalances of biochemical and genetic pathways, as well as the interconnection between them. Therefore, the equation changes in comparison to other critical patients or to healthy individuals, in which cases, mathematical equations can be successfully used to predict the energy requirements. Recent studies have shown that indirect calorimetry is one of the most accurate methods for determining the energy requirements in intubated and mechanically ventilated patients. Current research is oriented towards an individualized therapy depending on the energy consumption (kcal/day) of each patient that also takes into account the clinical dynamics. By using indirect calorimetry, one can measure, in real time, both oxygen consumption and carbon dioxide production. Energy requirements (kcal/day) and the respiratory quotient (RQ) can be determined in real time by integrating these dynamic parameters into electronic algorithms. In this manner, nutritional therapy becomes personalized and caters to the patients’ individual needs, helping patients receive the energy substrates they need at each clinically specific time of treatment.

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Section: Nutritional Therapy Guided With Indirect Calorimetry In Critsupporting

confidence: 53%

Section: Nutritional Therapy Guided With Indirect Calorimetry In Critmentioning

confidence: 99%

Assessment of Metabolic and Nutritional Imbalance in Mechanically Ventilated Multiple Trauma Patients: From Molecular to Clinical Outcomes

et al. 2019

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“…Since REE measurements in healthy growing preterm infants also include 1-1.2 kcal/kg weight gain (7), REE is directly related to growth rate. Accumulating evidence suggest that REE in preterm infants is around 35-60 kcal/kg/d when full enteral feeds are reached at around 2-4 weeks of age, rising with postnatal age up to 55-70 kcal/kg/d (8)(9)(10)(11)(12)(13). Meta-analysis of these data suggests a range for REE of 60-70 kcal/kg/d, depending on growth rate.…”

Section: Energy (Supplementary Digital Content 4 Http://linkslwwcom/m...mentioning

confidence: 99%

Enteral Nutrition in Preterm Infants (2022): A Position Paper From the ESPGHAN Committee on Nutrition and Invited Experts

Embleton

Moltu

Lapillonne³

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: To review the current literature and develop consensus conclusions and recommendations on nutrient intakes and nutritional practice in preterm infants with birthweight <1800 g. Methods: The European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee of Nutrition (CoN) led a process that included CoN members and invited experts. Invited experts with specific expertise were chosen to represent as broad a geographical spread as possible. A list of topics was developed, and individual leads were assigned to topics along with other members, who reviewed the current literature. A single face-to-face meeting was held in February 2020. Provisional conclusions and recommendations were developed between 2020 and 2021, and these were voted on electronically by all members of the working group between 2021 and 2022. Where >90% consensus was not achieved, online discussion meetings were held, along with further voting until agreement was reached. Results: In general, there is a lack of strong evidence for most nutrients and topics. The summary paper is supported by additional supplementary digital content that provide a fuller explanation of the literature and relevant physiology: introduction and overview; human milk reference data; intakes of water, protein, energy, lipid, carbohydrate, electrolytes, minerals, trace elements, water soluble vitamins, and fat soluble vitamins; feeding mode including mineral enteral feeding, feed advancement, management of gastric residuals, gastric tube placement and bolus or continuous feeding; growth; breastmilk buccal colostrum, donor human milk, and risks of cytomegalovirus infection; hydrolyzed protein and osmolality; supplemental bionutrients; and use of breastmilk fortifier. Conclusions: We provide updated ESPGHAN CoN consensus-based conclusions and recommendations on nutrient intakes and nutritional management for preterm infants

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“…Studies of REE during the first few weeks of life in healthy preterm and term infants show that REE increases with increasing energy supply during the first weeks of life and that REE is directly proportional to the growth rate (79,80) healthy preterm infants are around 35-55 kcal Á kg À1 Á day À1 during the first 2 weeks of life when nutrient intakes are low, and increase to about 70 kcal Á kg À1 Á day À1 at 1 month of age (80)(81)(82). In healthy term neonates, REE increases from 45 to 50 kcal Á kg À1 Á day À1 to about 60 kcal Á kg À1 Á day À1 during the same time interval (79,80).…”

Section: Energy Needs In Healthy and Critically Ill Neonates Energy N...mentioning

confidence: 99%

Nutritional Management of the Critically Ill Neonate

Moltu

Bronský

Embleton

et al. 2021

J. pediatr. gastroenterol. nutr.

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Objectives: The nutritional management of critically ill term neonates and preterm infants varies widely, and controversies exist in regard to when to initiate nutrition, mode of feeding, energy requirements, and composition of enteral and parenteral feeds. Recommendations for nutritional support in critical illness are needed. Methods: The ESPGHAN Committee on Nutrition (ESPGHAN-CoN) conducted a systematic literature search on nutritional support in critically ill neonates, including studies on basic metabolism. The Medline database and the Cochrane Library were used in the search for relevant publications. The quality of evidence was reviewed and discussed before voting on recommendations, and a consensus of 90% or more was required for the final approval. Important research gaps were also identified. Results: This position paper provides clinical recommendations on nutritional support during different phases of critical illness in preterm and term neonates based on available literature and expert opinion. Conclusion: Basic research along with adequately powered trials are urgently needed to resolve key uncertainties on metabolism and nutrient requirements in this heterogeneous patient population.

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Energy expenditure, growth, and nutritional therapy in appropriate and small for gestational age preterm infants

Cited by 7 publications

References 19 publications

Assessment of Metabolic and Nutritional Imbalance in Mechanically Ventilated Multiple Trauma Patients: From Molecular to Clinical Outcomes

Assessment of Metabolic and Nutritional Imbalance in Mechanically Ventilated Multiple Trauma Patients: From Molecular to Clinical Outcomes

Enteral Nutrition in Preterm Infants (2022): A Position Paper From the ESPGHAN Committee on Nutrition and Invited Experts

Nutritional Management of the Critically Ill Neonate

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