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Published on: November 11, 2021
[Resting energy expenditure in healthy newborn infants]
Chang-hong Lu1, Wei Cai, Qing-ya Tang
1Clinical Nutrition Center and Department of Pediatric Surgery, Xinhua Hospital and Shanghai Children's Medical Center, Shanghai Second Medical University, Shanghai 200092, China.
Insights
Resting energy expenditure (REE) in healthy newborns is lower than predicted by standard formulas. Indirect calorimetry is recommended for accurate REE measurement in infants.
Area of Science:
- Neonatal physiology
- Metabolic research
- Pediatric nutrition
Context:
- Accurate assessment of resting energy expenditure (REE) is crucial for understanding neonatal metabolism and nutritional needs.
- Existing predictive formulas may not accurately reflect REE in healthy newborns.
- Indirect calorimetry offers a precise method for measuring REE in this population.
Purpose:
- To determine the actual resting energy expenditure (REE) in healthy newborns.
- To evaluate factors influencing REE in neonates.
- To compare measured REE with values predicted by the Schofield formula.
Summary:
- This study measured the REE in 154 healthy newborns using indirect calorimetry.
- The average measured REE was 201.8 kJ/(kg·d), significantly lower than the 226.1 kJ/(kg·d) predicted by the Schofield formula.
- No significant differences in REE were observed based on sex or delivery method.
Impact:
- Findings suggest that standard predictive formulas may overestimate REE in healthy newborns.
- Indirect calorimetry is confirmed as a superior method for determining actual REE in neonates.
- The study provides a validated REE value for healthy newborns (201.8 ± 25.4 kJ/(kg·d)) for clinical and research applications.
Objective:
To establish the value of the resting energy expenditure (REE) in healthy newborns and evaluate relative factors of REE.
Methods:
One hundred and fifty-four healthy newborns (75 boys, 79 girls; birth-weight 2,500-3,999 g) were enrolled in this study. The Apgar score at the 5th minute was equal to or more than 8; the postnatal age was equal to or more than 5 days. The newborns had no apparent defect. The mothers had no history of metabolic and endocrine diseases. REE was measured by Deltatrac II in child canopy mode for 30-45 minutes during asleep or quiet awake status.
Results:
The average REE was (201.8 +/- 25.4) kJ/(kg.d), which was significantly lower than the predicted REE by Schofield formula[(226.1 +/- 4.8) kJ/(kg.d), P = 0.000], the predicted REE was 12.04% higher than the measured REE. There were no differences in sex and ways of delivery. The newborns whose birth-weight was between 2,500-2,999 g were measured in two modes: baby and child mode, and the REE values were significantly higher (122.6 +/- 25.0) kJ/(kg.d) and (208.8 +/- 26.4) kJ/(kg.d), respectively (P = 0.000).
Conclusions:
The prediction formula might be improper for calculating the REE in newborn infants. The indirect calorimetry was the better way to know the actual REE of newborns. The authors recommended that in child mode the measurement of REE in newborns would be the indirect calorimetry, and the REE in healthy newborns was (201.8 +/- 25.4) kJ/(kg.d).
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