Large left-to-right shunts and congestive heart failure increase total energy expenditure in infants with ventricular septal defect

Farrell, Anne G.; Schamberger, Marcus S.; Olson, Inger; Leitch, C. A.

doi:10.1016/s0002-9149(01)01479-5

Cited by 36 publications

(30 citation statements)

References 11 publications

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“…Also the lack of controls and standardization in the timing and methods of energy measurements make comparability between studies problematic (Gebara et al, 1992;Barton et al, 1994;Mitchell et al, 1994;Ackerman et al, 1998;Leitch et al, 1998Leitch et al, , 2000Farrell et al, 2001;Avitzur et al, 2003;van der Kuip et al, 2003). This is the first study to relate changes in energy expenditure and growth in children with CHD to the timing of corrective cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Changes in resting energy expenditure in children with congenital heart disease

et al. 2007

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Objectives: The aim of this study was to relate changes in energy expenditure and growth in infants with congenital heart disease (CHD), to the timing of corrective cardiac surgery. Methods: Prospective cohort study of infants less than 1 year with CHD admitted for cardiac surgery to Royal Children's Hospital, between January to September 2005. Infants were assessed using anthropometry and indirect calorimetry and compared to healthy age-matched controls. Results: Infants (38) underwent corrective (n ¼ 25) or palliative (n ¼ 13) cardiac surgery either at p10 days or at 410 days. Infants undergoing corrective surgery after 10 days had deficits in z-scores for weight compared with infants undergoing early surgery (À1.15 ± 1.02 vs À0.24 ± 0.98; CI 95%: À1.736 to À0.085; Po0.05) and height (À1.47 ± 1.16 vs À0.12 ± 0.66; CI 95%: À2.262 to À0.428; Po0.01). However, 6 months following surgery, weight and height were similar in both groups. Resting energy expenditure was increased before surgery compared to healthy controls (247 ± 36 vs 210 ± 22 kJ kg À1 day À1 ; 95% CI: À57.29 to À16.71; Po0.001) however, normalized 1 week following cardiac surgery. Standard equations did not accurately predict measured REE. Conclusion: Increased REE observed in infants with CHD normalizes within 1 week following corrective cardiac surgery. Deficits in weight and growth were greater in infants undergoing corrective cardiac surgery410 days of age compared with infants undergoing surgery in the first 10 days of life.

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Section: Discussionmentioning

confidence: 99%

Changes in resting energy expenditure in children with congenital heart disease

et al. 2007

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“…Studies of TEE in infants with CHD that either did not require surgery or who were measured prior to surgical intervention have yielded more consistent results. Two studies comparing TEE of infants with unrepaired VSD to healthy infants found TEE was significantly higher in infants with CHD at 4 months [15] and at 8 months of age [2]. Another study of infants with CHD (primarily VSD, ASD, and AVSD and a mean age of 4-5 months) found the mean pre-surgical TEE was significantly elevated compared to healthy controls [48].…”

Section: Discussionmentioning

confidence: 99%

“…Studies measuring total energy expenditure (TEE) in infants with CHD who have not undergone surgical intervention suggest TEE is elevated [2,15,48]. In comparison with healthy infants of similar age, TEE has been found to be higher in infants with ventricular septal defect (VSD) accompanied by large left-to-right shunts [2,15] and in infants with VSD or atrioventricular septal defects (AVSD) and large left-to-right shunts [48].…”

Section: Introductionmentioning

confidence: 99%

“…In comparison with healthy infants of similar age, TEE has been found to be higher in infants with ventricular septal defect (VSD) accompanied by large left-to-right shunts [2,15] and in infants with VSD or atrioventricular septal defects (AVSD) and large left-to-right shunts [48]. Data on TEE in infants with CHD who have undergone surgical intervention are limited and conflicting [4,29,41].…”

Section: Introductionmentioning

confidence: 99%

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Total Energy Expenditure of Infants with Congenital Heart Disease Who Have Undergone Surgical Intervention

et al. 2015

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Growth failure is often observed in infants with congenital heart disease (CHD); it is unclear, however, whether growth failure is due to increased total energy expenditure (TEE). An observational study of infants with CHD and surgical intervention within the first 30 days of life and healthy infants of similar age was undertaken. TEE was measured using the doubly labeled water method in 3-month-old infants (n = 15 CHD, 12 healthy) and 12-month-old infants (n = 11 CHD, 12 healthy). Multiple linear regression models were fit to examine the association between health status (CHD vs. healthy) and TEE. The accuracy of equations for calculating TEE was also determined. TEE for CHD infants was not significantly different from healthy infants at 3 and 12 months; TEE in CHD infants was 36.4 kcal/day higher (95 % CI -46.3, 119.2; p = 0.37) and 31.7 kcal/day higher, (95 % CI -71.5, 134.8; p = 0.53) at 3 and 12 months, respectively, compared to healthy infants. The 2002 Dietary Reference Intake (DRI) equation and the 1989 Recommended Dietary Allowance equation over-estimated measured TEE to a lesser extent than CHD specific equations; the 2002 DRI yielded the smallest mean difference between calculated versus measured TEE (difference 79 kcal/day). During the first year of life, TEE of infants with CHD and interventional surgery within the first month of life was not different than age-matched healthy infants. When calculating TEE of ≤12-month-old infants with CHD who have undergone surgical intervention, the 2002 DRI equation may be used as a starting point for estimating initial clinical energy intake goals.

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“…More contemporary studies have reported observing no difference in REE between infants with CHD and healthy controls; however, it is suggested that total energy expenditure (TEE), as determined by doubly labelled water technique, is responsible for growth failure rather than REE (Ackerman, Karn, Denne, Ensing, & Leitch, 1998;Farrell, Schamberger, Olson, & Leitch, 2001;Leitch et al, 1998;van der Kuip et al, 2003).…”

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confidence: 99%

Defining Fluid Restriction in the Management of Infants Following Cardiac Surgery and Understanding the Subsequent Impact on Nutrient Delivery and Growth Outcomes

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Large left-to-right shunts and congestive heart failure increase total energy expenditure in infants with ventricular septal defect

Cited by 36 publications

References 11 publications

Changes in resting energy expenditure in children with congenital heart disease

Changes in resting energy expenditure in children with congenital heart disease

Total Energy Expenditure of Infants with Congenital Heart Disease Who Have Undergone Surgical Intervention

Defining Fluid Restriction in the Management of Infants Following Cardiac Surgery and Understanding the Subsequent Impact on Nutrient Delivery and Growth Outcomes

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