Oxygen consumption and evaporative water loss in infants with congenital heart disease.

Kennaird, D L

doi:10.1136/adc.51.1.34

Cited by 23 publications

(7 citation statements)

References 39 publications

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“…At about this time she developed the physical signs of a patent ductis arteriosus with early congestive cardiac failure. A left-to-right shunt is known to increase metabolic rate (Kennaird, 1976). In conclusion, we found that a baby's metabolic rate could not be predicted by his birthweight and postnatal age, nor did we find any correlation between metabolic rate and rectal temperature.…”

Section: Discussioncontrasting

confidence: 60%

Variations in the resting oxygen consumption of small babies.

Rutter¹,

Brown²,

Hull³

1978

Arch Dis Child

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al., 1969). It is therefore current policy in many neonatal units to try to nurse small babies at a temperature at which heat production is at a minimum and at which sweating does not take place. The range of ambient temperature over which this occurs is termed thermoneutral, and estimates of this thermoneutral range have been made for babies of different birthweights and postnatal ages, and for both naked and clothed babies (Hey and Katz, 1970;Hey and O'Connell, 1970). These estimates are based on measurements of heat production and evaporative water loss from babies nursed in an experimental metabolism chamber at different ambient temperatures.In practice however, it has proved difficult to nurse babies according to Hey's recommendations which are based on average values of resting heat production and require that babies of the same birthweight and postnatal age are nursed under the same temperatures. It is our experience that nursing staff prefer to alter the incubator air temperature according to small changes in the baby's rectal temperature, whether his skin feels warm or cold, and whether he appears to be comfortable or restless. In effect, Received 8 December 1977 they feel that babies vary in their temperature requirements.The object of this inquiry was to examine the individuality of a group of small babies in a newborn nursery by measuring their rates of heat production serially. MethodHeat production was measured indirectly by determining 02 consumption using an open-circuit method, as described by Smales (1978). Warm, humid air was passed at a rate of 1 0 1/min through a soft rubber face mask secured over the baby's nose and mouth, and the 02 content of the outflow measured with a paramagnetic oxygen analyser (Servomex OA250). The rate Of 02 consumption is the product of the rate of flow and the difference in 02 concentration in the inflow and outflow gas. Measurements were made more than an hour after the end of a feed so as to minimise changes in 02 consumption due to the specific dynamic action of food. The baby usually settled and went to sleep after the face mask was applied, and a measurement was then made 10 to 15 minutes later. Measurements were made over a period of 3 to 15 minutes when the record was stable. The resting 02 consumption was calculated in ml/min, corrected to standard temperature and pressure, and expressed per kg body weight.Oxygen consumption was measured serially in 15 babies. The first measurement was made within 24 hours of delivery and subsequent measurements were made daily for the first few days and then less 850 on 11 May 2018 by guest. Protected by copyright.

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Section: Discussioncontrasting

confidence: 60%

Variations in the resting oxygen consumption of small babies.

Rutter¹,

Brown²,

Hull³

1978

Arch Dis Child

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“…This was somewhat surprising in'view of a previous report in awake children that showed a decreased metabolic rate in connection with chronic hypoxaemia (Kennaird 1976). The metabolic rate in that study was most constantly reduced when children had arterial O2 tensions lower than 55 mmHg (7.3 Wa).…”

Section: Discussionmentioning

confidence: 71%

“…Thus, a lower metabolic rate in hypoxaemic children was also expected in this study. Many of the acyanotic children in the previous study by Kennaird (1976) were, however, in congestive heart failure requiring both digitalis and diuretics. Infants and children with a failing heart function have a higher oxygen consumption and metabolic rate than those who have normal heart functions (Pittman & Cohen 1964;Lees 1966).…”

Section: Discussionmentioning

confidence: 92%

“…These variables were related to weight according to the following expressions: Vo2 (ml min-I) = 6.1 x kg + 21.6, r = 0.95; Vco, (ml min-') = 5.7 x kg + 2.9, r = 0.96, and E (kcal h-') 1.8 x kg + 5.3; E (J h-') = 7.6 x kg + 22.3, r = 0.96. Fluid volumes (FV) could be calculated according to the expression: FV (ml h-l) = 3.0 x kg + Introduction Chronic hypoxaemia has been stated as a cause of decreased metabolic rate in awake infants and children (Kennaird 1976). In two recent reports, carbon dioxide elimination (Vco,) also appeared to be lower in anaesthetized children with cyanotic than in those with acyanotic congenital heart malformations (Lindahl & Olsson 1987;Fletcher 1988).…”

Section: Summa Ymentioning

confidence: 99%

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Gas exchange, metabolic rate and fluid requirements during anaesthesia of acyanotic and cyanotic infants and children with congenital heart malformations

Grigsby

Beynen

Lindahl³

1991

Pediatric Anesthesia

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Summa yIn order to study gas exchange and metabolic rate in anaesthetized children scheduled for corrective cardiac surgery and to find out if chronic hypoxaemia influenced gas exchange and energy expenditure, oxygen consumption (VOZ) and carbon dioxide elimination (Vco,) were measured and energy expenditure ( E ) was calculated. Infants and children whose haematocrit (Hct) was less than 44% and arterial oxygen saturation (Saoz) on room-air was greater than 93% were classified as acyanotic (group AC, n = 11, weight range 3.7 to 20 kg), and those whose Hct was higher than 44% and Saoz less than 93% as cyanotic (group C, n = 14, weight range 3.4 to 24.3 kg). The majority of children in both groups weighed less than the 50th percentile for normal children. There was no difference in Voz, Vcoz and E between the groups. These variables were related to weight according to the following expressions: Vo2 (ml min-I) = 6.1 x kg + 21.6, r = 0.95; Vco, (ml min-') = 5.7 x kg + 2.9, r = 0.96, and E (kcal h-') 1.8 x kg + 5.3; E (J h-') = 7.6 x kg + 22.3, r = 0.96. Fluid volumes (FV) could be calculated according to the expression: FV (ml h-l) = 3.0 x kg + 8.7; r = 0.96. Oxygen consumption was 15 to 20% higher in anaesthetized infants and children with congenital heart malformations than in anaesthetized infants and children with normal cardiopulmonary function. Accordingly, energy expenditure and fluid requirements were also higher. This difference was most probably due to an undernutrition in children with congenital heart malformations which resulted in a compensatory hypermetabolism.

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“…Intraoperative thermoregulatory responses during the thermal steady-state may actually increase central temperature in children despite constant ambient temperatures (7). In patients with severe acyanotic CHD, minimum oxygen consumption and heat production is increased, and low cardiac output and peripheral vasoconstriction reduce the redistribution of heat from the core to the periphery (8).…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic Hyperthermia During Cardiac Magnetic Resonance Imaging

Kussman¹,

Mulkern²,

Holzman³

2004

Anesthesia & Analgesia

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We report the occurrence of accidental hyperthermia in a young child undergoing anesthesia for cardiac magnetic resonance imaging. Although the tendency during anesthesia is to develop hypothermia, the absorbed radiofrequency energy from magnetic resonance scanning is added to metabolic energy and must be balanced by appropriate heat loss to maintain normothermia. In addition to stressing the clinical importance of temperature monitoring, this report suggests that the recommended specific absorption rates to prevent excessive patient heating may need to be revised for infants and young children.

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Oxygen consumption and evaporative water loss in infants with congenital heart disease.

Cited by 23 publications

References 39 publications

Variations in the resting oxygen consumption of small babies.

Variations in the resting oxygen consumption of small babies.

Gas exchange, metabolic rate and fluid requirements during anaesthesia of acyanotic and cyanotic infants and children with congenital heart malformations

Iatrogenic Hyperthermia During Cardiac Magnetic Resonance Imaging

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