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Longitudinal measurements of oxygen consumption in growing infants during the first weeks after birth: old data
J C Sinclair1, K Thorlund, S D Walter
1Department of Pediatrics, McMaster University, Hamilton, Ont., Canada. sinclair@mcmaster.ca
Insights
Minimal oxygen consumption (V·O2) in infants increases with body size and age. This study established reference intervals for V·O2 in growing infants during the 1960s using advanced statistical models.
Area of Science:
- Neonatal physiology
- Pediatric metabolism
- Infant growth and development
Background:
- Longitudinal metabolic rate measurements in infants were conducted between 1966-1969.
- Advanced statistical methods for analyzing longitudinal data were not widely available at that time.
Purpose of the Study:
- To measure minimal oxygen consumption (V·O2) rates in infants during early postnatal weeks.
- To determine the relationship between V·O2, body size, and postnatal age.
Main Methods:
- 61 infants, including 19 of very low birth weight, were studied.
- Serial V·O2 measurements were taken weekly under thermoneutral conditions using a closed-circuit method.
- Mixed-effects models were employed for data analysis.
Main Results:
- V·O2 increased with surface area and body weight during early postnatal growth.
- Multivariate analyses confirmed significant effects of both size and age on V·O2.
- Reference intervals for V·O2 were established based on body weight and postnatal age.
Conclusions:
- Mixed-effects models enabled the generation of reference intervals for infant V·O2 from 1960s data.
- The findings are applicable to neonatal care practices prior to the widespread use of caffeine.
Background:
In a study conducted in 1966-1969, longitudinal measurements were made of the metabolic rate in growing infants. Statistical methods for analyzing longitudinal data weren't readily accessible at that time.
Objectives:
To measure minimal rates of oxygen consumption (V·O2, ml/min) in growing infants during the first postnatal weeks and to determine the relationships between postnatal increases in V·O2, body size and postnatal age.
Methods:
We studied 61 infants of any birth weight or gestational age, including 19 of very low birth weight. The infants, nursed in incubators, were clinically well and without need of oxygen supplementation or respiratory assistance. Serial measures of V·O2 using a closed-circuit method were obtained at approximately weekly intervals. V·O2 was measured under thermoneutral conditions with the infant asleep or resting quietly. Data were analyzed using mixed-effects models.
Results:
During early postnatal growth, V·O2 rises as surface area (m(2))(1.94) (standard error, SE 0.054) or body weight (kg)(1.24) (SE 0.033). Multivariate analyses show statistically significant effects of both size and age. Reference intervals (RIs) for V·O2 for fixed values of body weight and postnatal age are presented. As V·O2 rises with increasing size and age, there is an increase in the skin-operative environmental temperature gradient (T skin-op) required for heat loss. Required T skin-op can be predicted from surface area and heat loss (heat production minus heat storage).
Conclusions:
Generation of RIs for minimal rates of V·O2 in growing infants from the 1960s was enabled by application of mixed-effects statistical models for analyses of longitudinal data. Results apply to the precaffeine era of neonatal care.
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