Oxygen consumption, energy expenditure, and substrate utilization after cardiac surgery in children

Predicted versus measured energy expenditure by continuous, online indirect calorimetry in ventilated, critically ill children during the early postinjury period*

“…This is consistent with other published data (5,6,(15)(16)(17). Several factors can explain this hypometabolism such as initial resuscitation, mechanical ventilation (which reduces the cost of breathing) (54), administration of analgesia, sedation and neuromuscular blockade (17,55), and malnutrition.…”

“…Few studies have measured energy expenditure during the early postinjury period, and none have validated the predictive equations during this period in critically ill children. Most reports have studied energy expenditure in later postinjury stages, usually critically ill children with a length of stay in the PICU Ͼ1 day (4,5,15,44). Aiming to improve the accuracy of the MEE, we performed continuous on-line indirect calorimetry for 24 hrs because there are no established standards that define the period during which the test must be performed (45,46).…”

“…Thus, longer indirect calorimetry studies, such as continuous on-line indirect calorimetry performed for 24 hrs, have shown that mechanically ventilated adult patients are in an hypermetabolic state during the early postinjury period (4). Different conclusions have been reached when other investigators have performed shorter indirect calorimetry studies (5)(6)(7). Metabolic response in children seems to be faster (8).…”

Changes in resting energy expenditure in children with congenital heart disease

“…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.…”

Serial measurements of energy expenditure in critically ill children: useful in optimizing nutritional therapy?

“…Therefore individual measurements of energy expenditure by means of indirect calorimetry are necessary for tailoring adequate nutritional support [8,9]. Studies of serial measurements of energy expenditure are limited in critically ill children [10,11]. Recently Briassoulis et al [10] found no significant change in the ratio measured energy expenditure/ predicted basal metabolic rate during the first 7 days of admission in ten critically ill children.…”