Related Experiment Videos
Energy expenditure and energy intake during dexamethasone therapy for chronic lung disease
C A Leitch1, J Ahlrichs, C Karn
1Department of Pediatrics, Indiana University School of Medicine, Indianapolis 46202-5210, USA.
Insights
Dexamethasone treatment in preterm infants with chronic lung disease did not increase energy expenditure or decrease energy intake, despite reduced weight gain. The cause of decreased growth may be altered tissue composition.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Clinical Nutrition
Background:
- Dexamethasone is frequently used for ventilator-dependent preterm infants with chronic lung disease.
- Infants undergoing dexamethasone therapy often show reduced weight gain.
- The underlying mechanism for this growth reduction requires investigation.
Purpose of the Study:
- To determine if increased energy expenditure causes decreased growth in infants receiving dexamethasone.
- To assess the impact of dexamethasone on energy intake and expenditure in preterm infants.
Main Methods:
- A crossover study design was employed with 12 preterm infants.
- Infants received either dexamethasone or placebo treatment, with treatment order reversed.
- Energy expenditure and intake were measured using the doubly labeled water method over a 1-week period during each treatment phase.
Main Results:
- No significant differences in energy expenditure were observed between dexamethasone and placebo treatments (93.1+/-34.6 vs. 88.3+/-37.1 kcal/kg/d).
- Energy intake also showed no significant difference between treatment groups (119.2+/-29.0 vs. 113.8+/-23.7 kcal/kg/d).
- The energy available for growth was similar during both treatment phases.
Conclusions:
- Decreased weight gain in infants receiving dexamethasone is not attributable to increased energy expenditure or reduced energy intake.
- The findings suggest that altered composition of newly accreted tissue may explain the reduced growth observed during dexamethasone therapy.
Abstract:
Dexamethasone is commonly administered to ventilator-dependent preterm infants with chronic lung disease. Infants receiving dexamethasone therapy frequently exhibit decreased rates of weight gain. The purpose of this investigation was to determine whether decreased growth in infants receiving dexamethasone therapy is caused by increased energy expenditure. Twelve infants were studied: 6 received dexamethasone treatment at 2 wk of age and crossed over to receive placebo treatment at 4 wk; the treatment order was reversed in the other 6 infants. The doubly labeled water method was used to determine energy expenditure for a 1-wk period during each treatment phase. The rate of weight gain during dexamethasone treatment was 6.5+/-10.6 and 20.0+/-5.7 g/kg/d during placebo treatment. Energy expenditure was 93.1+/-34.6 kcal/kg/d during dexamethasone treatment and 88.3+/-37.1 kcal/kg/d during placebo treatment. Energy intake was 119.2+/-29.0 kcal/kg/d during dexamethasone treatment and 113.8+/-23.7 kcal/kg/d during placebo treatment. The difference between intake and expenditure, or the energy available for growth, was 26.2+/-36.8 kcal/kg/d during dexamethasone treatment and 25.5+/-37.4 kcal/kg/d during placebo treatment. No significant differences were found in energy expenditure or energy intake between the treatment phases. The reduced growth seen in infants receiving dexamethasone treatment cannot be explained by increased energy expenditure or decreased energy intake, but may be due to differences in the composition of newly accreted tissue.