Measured Energy Expenditure in Mechanically Ventilated Very Low Birth Weight Infants

Samiec, Tamisha D.; Radmacher, Paula G.; Hill, Tami; Adamkin, David H.

doi:10.1097/00000441-199403000-00004

Cited by 11 publications

(4 citation statements)

References 11 publications

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“…We found a positive energy balance during the entire observation period. In two previous studies on EI and EE in ELBW infants with postnatal age , 7 d, EI was only 126 and 155 kJ/kg per d and the EE was 205 and 230 kJ/ kg per d, thus resulting in a highly negative energy balance (Samiec et al 1994;Wahlig et al 1994). Gudinchet et al (1982) found a positive energy balance in two preterm infants with birth weight , 1000 g of 140 kJ/kg at 7 d of age.…”

Section: Discussionmentioning

confidence: 90%

Longitudinal evaluation of energy expenditure in preterm infants with birth weight less than 1000 g

et al. 2003

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The aim of the present study was to obtain serial values of O 2 consumption (V O 2 ), CO 2 production (V CO 2 ) and energy expenditure (EE) in healthy but extremely-low-birth-weight infants (birth weight , 1000 g), during the first 5 weeks after birth. A total of seventeen spontaneously breathing and appropriate-for-gestational-age (birth weight and body length above the 10th and below the 90th percentile) preterm infants with gestational age 25 -28 weeks and birth weight 590-990 g were enrolled in the study. Calorimetry was performed using an open-circuit calorimeter on days 6, 12, 18, 24, 30 and 36 of postnatal life. During the 5 weeks of observation, V O 2 increased from 4·7 (SD 0·5) to 9·1 (SD 1·0) ml/kg per min, V CO 2 from 4·5 (SD 0·4) to 8·3 (SD 0·6) ml/kg per min and EE from 115 (SD 12) to 310 (SD 71) kJ/kg per d. The energy intake was always higher than EE, even at days 6 and 12. The RER decreased from 0·99 (SD 0·09) at day 12 to 0·91 (SD 0·05) at day 30. On all study days, there were highly significant positive correlations between energy intake and weight gain, EE and weight gain, and EE and energy intake (P,0·05). Multiple regression analysis showed that on most study days EE was more affected by energy intake than by weight gain. We conclude that in healthy preterm infants with birth weight , 1000 g, EE increases by about 150 % in the first 5 weeks after birth, and that the EE values are related to energy intake and weight gain independent of postnatal age. Energy expenditure: Growth: Preterm: Oxygen consumptionThe substantial improvement of the survival rate in extremely-low-birth-weight (ELBW) infants (birth weight , 1000 g) has changed the focus towards prevention of long-term morbidity. Adequate nutrition is an important prerequisite for intact survival of ELBW infants (Lucas, 1987;Lucas et al. 2001). Determinations of energy requirements are usually based on calculation of the energy balance (= energy intake (EI) -energy loss via faeces and urineenergy expenditure (EE)). Energy loss via faeces and urine is about 10 % EI, independent of postnatal age and EI in preterm infants (Sauer et al. 1984a). However, EE tends to increase with increasing age. Chessex et al. (1981) suggested that EE increases with age of preterm infants due to increasing EI. Their assumption was based on only three serial studies in preterm infants with a mean birth weight of 1155 (SD 39) g. Leitch & Denne (2000) summarised published EE values measured in seventy-five preterm infants with birth weight , 1000 g v. postnatal age, and found an increase of EE from 209 kJ/kg per d at birth to 272 kJ/kg per d at 5 weeks of age. However, thirty-five of the seventy-five infants were small-for-gestational-age with a mean postnatal age of 6·0 weeks, whereas forty infants had birth weights appropriate for gestational age and mean postnatal age of 2·5 weeks. Thus, the apparent increase in EE with age may be due in part to higher EE of small-for-gestational-age infants (Boehler et al. 1999).Recommendations for EI and dietary intakes are ...

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Section: Discussionmentioning

confidence: 90%

Longitudinal evaluation of energy expenditure in preterm infants with birth weight less than 1000 g

et al. 2003

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“…Our study was not designed to study the effect of specific medications on EE. It is often assumed that methyl-xanthines increase basal metabolic rate, although the only studies investigating their effects on energy expenditure in neonates were not able to demonstrate group differences between patients who were and those who were not receiving methyl-xanthines [6,17]. Glucocorticoids are known to have significant metabolic effects in preterm infants [22].…”

Section: Discussionmentioning

confidence: 99%

“…In non-ventilated very low birthweight infants [4] evaluated the relative importance of postnatal age (PNA), energy intake and weight gain on metabolic rate and demonstrated a strong correlation between energy intake and metabolic rate. More recently, several studies have reported metabolic rates in ventilated low birthweight infants [1,7,8,10,11,14,17,20,23]. However, few of these studies have examined the determinants of energy expenditure in this population of ventilated preterm infants [1,8,17].…”

Section: Introductionmentioning

confidence: 99%

“…More recently, several studies have reported metabolic rates in ventilated low birthweight infants [1,7,8,10,11,14,17,20,23]. However, few of these studies have examined the determinants of energy expenditure in this population of ventilated preterm infants [1,8,17]. The purpose of this study was to measure VO 2 , VCO 2 , and EE in a group of preterm ventilated neonates over the first weeks of life, and to determine the primary influences on energy expenditure to facilitate estimation of nutritional support requirements in this population.…”

Section: Introductionmentioning

confidence: 99%

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Determinants of energy expenditure in ventilated preterm infants

DeMarie¹,

Hoffenberg²,

Biggerstaff³

et al. 1999

Journal of Perinatal Medicine

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The purpose of this study was to determine oxygen consumption (VO2), carbon dioxide production (VCO2), and energy expenditure (EE) in a group of preterm ventilated infants during the first 3 weeks of life, and to determine the major factors that influence EE. Thirty-eight indirect calorimetry studies were performed in 18 ventilated infants with mean gestational age of 27.9 +/- 0.6 (SEM) weeks. The relationship of demographic factors, nutrient intake, and severity of illness assessments of EE were determined by regression analysis. Repeated measure analysis was performed for the effect of multiple studies in the same patient. Although VO2, VCO2, and EE all tended to increase over the first 3 weeks of life, there was a wide range of values. EE was best predicted by nonprotein calorie intake and postnatal age, while there was no correlation with birthweight, weight at the time of study, gestational age, protein intake, or severity of illness. Multiple regression analyses demonstrated a strong interaction between PNA and EI. In this population EE is best predicted by PNA and EI. The interactive effect between PNA and EI on EE is probably explained by the clinical practice of daily increments in substrate intake in these patients.

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Nutritional Support in Respiratory Failure

Adamkin

2022

Manual of Neonatal Respiratory Care

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Measured Energy Expenditure in Mechanically Ventilated Very Low Birth Weight Infants

Cited by 11 publications

References 11 publications

Longitudinal evaluation of energy expenditure in preterm infants with birth weight less than 1000 g

Longitudinal evaluation of energy expenditure in preterm infants with birth weight less than 1000 g

Determinants of energy expenditure in ventilated preterm infants

Nutritional Support in Respiratory Failure

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