Increased O₂ Consumption and Energy Loss in Premature Infants following Medical Care Procedures

Abstract

Oxygen consumption (VO₂) and CO₂ production (VCO₂) were measured continuously for 24 h in 10 premature infants during their ongoing nursing care. Using a flow-through technique, the total VO₂ and VCO₂ over a given period of time were determined from the area under the O₂- and CO₂-concentration-time curve of the mixed expired gas. Following chest physiotherapy, heel stick and i.v. needle insertion, there was a significant (p < 0.01) increase in VO₂ and VCO₂. When measured for 24 h, the total daily increase of VO₂ attributed to these procedures ranged from 2.1 to 11.7% of total daily VO₂ equivalent to an estimated energy loss of 0.6–4.1 kcal/kg/day.

Premature Infants Are Less Capable of Maintaining Thermal Balance of Head and Body with Increases of Thermal Environment than with Decreases

“…No other interventions were performed to avoid increases in metabolic rate. 36 We did not measure Vo 2 or evaporative heat loss. The hand-held evaporimeter requires that the incubator portholes be opened.…”

Chest physiotherapy and porencephalic brain lesions in very preterm infants

“…Chest physiotherapy had been an integral part of the care of ventilated preterm infants for many years, in the early years being used by some hourly for the duration of intubation 7 . In the 1980s, there was great variation between neonatal units in the use of chest physiotherapy, with some units using it routinely 1–2 hourly in all babies recovering from respiratory distress syndrome 8 . Our practice was of selective use up to five times a day.…”

“…7 In the 1980s, there was great variation between neonatal units in the use of chest physiotherapy, with some units using it routinely 1-2 hourly in all babies recovering from respiratory distress syndrome. 8 Our practice was of selective use up to five times a day. The number of treatments given per baby decreased in our nursery in 1989.…”

Respiratory Failure in the Neonate—Preferred Practice Pattern 6G

“…[67][68][69] Therefore it is important that airway clearance procedures be performed only when clearly indicated for an existing problem or when a potential problem in an infant at risk is to be prevented. Sick neonates, especially those who are preterm, often do not tolerate handling well, even for routine and necessary procedures.…”