The Basal Metabolism of Prematurity

Talbot, Fritz B.; Sisson, Warren R.; Moriarty, Margaret E.; Dalrymple, Alice J.

doi:10.1001/archpedi.1922.04120080002001

Cited by 12 publications

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“…Except for the thermoregulatory heat production, all the components involved in the energy metabolism of fullterm and premature infants were studied and considered in the classical work of TALBOT et al [27,28] and later in the investigations of GORDON and LEVINE [9,10,13,14].…”

Section: Discussionmentioning

confidence: 99%

“…estimates, and do not reflect the changing partitioning of total metabolism between its main components Since TALBOT et al [28,29] and GORDON and LEVINE under different conditions. Hence, it seemed desirable [9,10,13,14] reported fundamental observations on and interesting to study the total energy expended the energy expenditure of full-term and premature in-during a period of several hours under conditions most fants, new knowledge has accumulated and has pro-commonly encountered in different infant care pracfound bearing on our understanding of basal metabolic tices.…”

Section: Introductionmentioning

confidence: 99%

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The Total Energy Expenditure and its Components in Premature Infants Maintained under Different Nursing and Environmental Conditions

1968

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ExtractIt seemed desirable and interesting to study the total energy expended during a period of several hours under conditions most commonly encountered under different infant care practices.The investigations were carried out on a total of 23 premature infants with a birth weight ranging from 1100 to 2120 g and aged from 2 to 31 days. Oxygen consumption was measured by an open circuit method using the Kipp diaferometer. Using three thermal conditions, measurements were started when four hours had elapsed after the last feed. Physical activity was observed and recorded continuously by an arbitrary method. The basal metabolic rate and the metabolic response to cold subtracted from the total metabolism measured under different experimental conditions gave the combined number of calories produced by specific dynamic action and physical activity. The information obtained from a previous study on specific dynamic action made it possible to approximate the calorigenic effect of food in the four series of examinations reported.Details of the studies carried out on premature infants while receiving human milk and kept in incubators with temperature maintained between 33-36° are shown in table I. In addition to the basal metabolic rate, total heat production observed throughout the observational period, calculated total daily heat production, and the percentage distribution of times spent in sleep and in physical activity with various intensity are also listed.. The average total heat production observed exceeds the minimal metabolic rate by 9.8 kcal/kg/24 h per subject. If allowance is made for the specific dynamic action expected from the average daily intake of human milk (1.1 g protein/ml) 3.0 kcal/kg/24 h can be attributed to muscular activity. The magnitude of this component of the total energy expenditure is consistent with the markedly reduced physical activity exhibited by premature infants maintained in a thermally neutral environment.The results obtained on premature infants receiving an artificial formula containing 3.43 % protein are listed in table II and shown diagrammatically in figure 1. The total daily caloric output averages 55.0 kcal/kg/24 h, a value roughly 39% above the basal rate, in contrast to the average increase of 25 % observed in breast milk-fed infants. This difference in the combined quota of specific dynamic action and physical activity (8.8 and 15.3 kcal/kg/24 h, respectively) is due partly to the higher protein and caloric intake, and partly to the lesser proportion of time spent in deep sleep. Table III summarizes the results of studies of the energy exchange of five swaddled premature infants kept at a room temperature of 20-22°. It can be seen that the total daily heat production averages 58.3 kcal/kg/24 h, which is not appreciably greater than that observed in Adapta-fed infants maintained at neutral temperature. The extra calories above the basal amount to 18.6 kcal/kg/24 h, II Pediat. Res., Vol. 2, No. 3 (1968) 162 MESTYAN, JARAI, FEKETE representing a 47 % rise above the minim...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Total Energy Expenditure and its Components in Premature Infants Maintained under Different Nursing and Environmental Conditions

1968

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“…Early twentieth century papers provided generalizations of the characteristics of premature infants rather than gestational age categories. A study in 1923 described the criteria for establishing prematurity as “weight, length, and general characteristics, such as facies, texture of the skin, undeveloped nails, cry, unstable temperature and history of expected birth” (Talbot et al 1923 ). At this time, factors beyond gestational age were considered to contribute to the definition of prematurity, including birth weight.…”

Section: Assessmentmentioning

confidence: 99%

“…In 1920 Schwarz and Kohn analyzed low birth weight stating “we have arbitrarily made 2500 g or under, the weight designated as low birth weight” and found that low birth weight infants had ten times the mortality of normal weight infants in the first month (Schwarz and Kohn 1921 ). A 1923 study on prematurity used a series of 20 infants with the largest infant weighing only 2098 g (Talbot et al 1923 ) whereas a 1927 study included weights up to 3000 g (Hess and Chamberlin 1927 ). Capper’s ( 1928 ) study used 2500 g but then concluded only 72 % of those <2500 g were premature, acknowledging a demarcation between the definition of low birth weight and prematurity (Capper 1928 ).…”

Section: Assessmentmentioning

confidence: 99%

2500-g Low Birth Weight Cutoff: History and Implications for Future Research and Policy

Hughes

Black

Katz

2016

Matern Child Health J

173

126

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Purpose To research the origins of the 2500 g cutoff for low birth weight and the evolution of indicators to identify newborns at high mortality risk. Description Early research concluded “prematurity”, measured mainly through birth weight, was responsible for increased health risks. The World Health Organization’s original prematurity definition was birth weight ≤2500 g. 1960s research clarified the difference between gestational age and birth weight leading to questions of the causal role of birth weight for health outcomes. Focus turned to two etiologies of low birth weight, preterm births and intrauterine growth restriction, which were both causally associated with morbidity and mortality but through different pathways; a standard cutoff based on gestational age or customized cutoff was debated. Assessment While low birth weight can be due to preterm or intrauterine growth restriction (or both), the historic 2500 g cutoff remains the standard by which the majority of policy makers define low birth weight and use it to predict perinatal and infant adverse outcomes. Conclusion Current efforts to refocus research on preterm births and poor intrauterine growth are important to understanding the direct causes of mortality rather than low birth weight as a convenient surrogate. Such distinctions also allow researchers and practitioners to test and target interventions outcomes more effectively.

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The Basal Metabolism of Prematurity

Talbot¹

1923

Am J Dis Child

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The object of the present study, commenced two years ago, was to gain further knowledge of the premature infant, and, if possible, to establish the physiologic basis for the nutritional requirements of these infants.A review of the literature showed that few studies had been made on the metabolism of premature infants. Some of these studies cannot be accurately interpreted because of differences in technical methods. This is particularly true of Rubner and Langstein's 1 and Weiss' cases.2 The investigations of Hasselbalch,3 although carried out with a slightly different technic, are comparable, because they were obtained under basal conditions. The cases reported by Fleming, Murlin and Marsh 4 and Benedict and Talbot5 are strictly comparable. So far as we know, there have been no comprehensive studies of the basal metabolism of prematurity before the present series and the one subsequently reported by Murlin. Most of the data in Table 1 appear in scattered publications incidental to other pieces of work. The results of these investigations are also recorded in the table.A study of the figures of the heat production per unit of body surface in the table shows a wide variation in results. Rubner and Langstein's findings are much higher than those of the other investi¬ gators and presumably do not represent basal figures. The striking feature brought out by the results of the other investigators is the very low heat production of the premature infant.The series reported below includes determinations of the basal metabolism of twenty-one premature infants. Some of the results have already been published in preliminary reports.6

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The Basal Metabolism of Prematurity

Cited by 12 publications

References 0 publications

The Total Energy Expenditure and its Components in Premature Infants Maintained under Different Nursing and Environmental Conditions

The Total Energy Expenditure and its Components in Premature Infants Maintained under Different Nursing and Environmental Conditions

2500-g Low Birth Weight Cutoff: History and Implications for Future Research and Policy

The Basal Metabolism of Prematurity

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