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Resting Energy Expenditure Measured by Indirect Calorimetry in Infants and Young Children with Chronic Lung Disease

Watsamon Jantarabenjakul, Sompol Sanguanrungsirikul, Suchada Sritippayawan

    Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
    |June 29, 2018
    PubMed

    Insights

    Indirect calorimetry is recommended for measuring resting energy expenditure (REE) in pediatric patients with chronic lung diseases. The Schofield-Weight/Height equation accurately predicts REE in this population.

    Area of Science:

    • Pediatric critical care
    • Nutritional science
    • Respiratory medicine

    Background:

    • Chronic lung diseases in infants and young children often lead to altered metabolic states.
    • Accurate assessment of resting energy expenditure (REE) is crucial for optimizing nutritional support in these vulnerable patients.
    • Indirect calorimetry is the gold standard for measuring REE, but prediction equations are often used for convenience.

    Purpose of the Study:

    • To determine resting energy expenditure (REE) using indirect calorimetry in pediatric patients with chronic lung diseases.
    • To compare measured REE (mREE) with predicted REE (pREE) from various established equations.
    • To identify the most accurate prediction equation for REE in this specific patient group.

    Main Methods:

    • Indirect calorimetry was performed using a custom-made airtight canopy in 18 infants and young children with chronic lung diseases.
    • Nutritional status and disease severity were assessed.
    • Measured REE was compared to predicted REE from FAO/WHO/UNU, Schofield-Weight, Schofield-Weight/Height, Harris Benedict, and Harris Benedict-Infant equations using Bland-Altman analysis.

    Main Results:

    • Eighteen patients (median age 6 months) were recruited, with 16 showing significant undernutrition (weight-for-age Z-score < -2).
    • Median measured REE was 53.8 kcal/kg/day.
    • The Schofield-Weight/Height equation demonstrated the lowest mean difference (0.94 kcal/kg/day) between measured and predicted REE.

    Conclusions:

    • Indirect calorimetry is essential for accurate REE measurement in pediatric patients with chronic lung diseases to guide nutritional therapy.
    • The Schofield-Weight/Height equation is the most reliable predictor of REE in this population among the tested equations.
    • Optimizing nutritional support through precise energy expenditure assessment is vital for managing chronic lung diseases in children.
    Abstract

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