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Published on: November 11, 2021
Changes in energy expenditure in preterm infants during weaning: a randomized comparison of two weaning methods from
Valentin Weintraub1, Francis B Mimouni, Shaul Dollberg
1Department of Neonatology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, 64239, Israel.
Insights
Weaning preterm infants from incubators increases resting energy expenditure (REE). A warming bassinet method delayed this REE increase compared to an open incubator method.
Area of Science:
- Neonatology
- Pediatric Metabolism
- Infant Thermoregulation
Background:
- Preterm infants require specialized thermal support.
- Weaning from incubator care is a critical step in neonatal intensive care.
- Understanding the metabolic impact of different weaning methods is essential for optimizing infant care.
Purpose of the Study:
- To compare resting energy expenditure (REE) in preterm infants weaned using an open incubator versus a warming bassinet.
- To confirm the expected increase in REE during the process of incubator weaning.
- To evaluate the temporal changes in REE following different weaning strategies.
Main Methods:
- Prospective randomized clinical trial involving preterm infants.
- Indirect calorimetry used to measure REE at multiple time points (baseline, 6, 23, 30, 47 hours post-weaning).
- Infants randomized to either an "open incubator" group or a "warming bassinet" group.
Main Results:
- Resting energy expenditure (REE) increased significantly in both groups within 23 hours of weaning.
- The "open incubator" group showed a significantly higher increase in REE at 6 and 23 hours compared to the "warming bassinet" group.
- By 30 and 47 hours post-weaning, REE levels became similar between the two groups.
Conclusions:
- Incubator weaning leads to a significant increase in resting energy expenditure (REE).
- The warming bassinet method appears to delay the metabolic adaptation (increased REE) observed with incubator weaning.
- Further research is needed to determine if one method offers advantages regarding thermic stress.
Abstract:
We aimed to compare resting energy expenditure (REE) of infants exposed to either one of two weaning methods and to confirm the increase in REE during weaning from incubator. The study was a prospective randomized clinical trial of weaning preterm infants using either of two methods. REE was measured at baseline and 6, 23, 30, and 47 h, using indirect calorimetry. At measurement, infants were clinically and thermally stable, asleep, 2 h after feeding. Forty-two patients were randomized to "open incubator" (n = 23) or "warming bassinet" (n = 19). The groups did not differ in baseline clinical characteristics. REE increased significantly in both groups within 23 h, and remained stable at 30 and 47 h. At 6 and 23 h, the incubator group had significantly higher increase in REE than the warming bassinet group. By 30 h and at 47 h post-weaning, the REE of both groups became similar. In conclusion, REE increases significantly at weaning from incubator. The warming bassinet delays the increase in REE observed when infants are weaned using a turned off incubator. Whether one method is superior to the other in terms of thermic stress cannot be determined from this study.
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