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Changes in the body composition of the surgical infant in the early postoperative period
Insights
Postoperative nutritional management in infants after major surgery leads to weight gain primarily through fat accretion. This early nutritional support is crucial for synthesizing new tissues and energy storage in surgical infants.
Area of Science:
- Pediatric Surgery
- Nutritional Science
- Body Composition Analysis
Background:
- Infants undergoing major surgery require careful nutritional management.
- Understanding early postoperative body composition changes is vital for optimizing growth and recovery.
Purpose of the Study:
- To evaluate the impact of postoperative nutritional strategies on infant body composition.
- To assess changes in total body water, total body fat, and lean body mass.
Main Methods:
- Study included 13 full-term infants post-major surgery.
- Total body water measured via isotope dilution (H2(18)O).
- Total body fat estimated from anthropometry; lean body mass calculated.
Main Results:
- Infants gained weight (5.9 g/kg/d) over seven days.
- Significant increase in total body fat (from 12.9% to 14%) observed.
- Protein, fat, and carbohydrate accretion rates determined.
Conclusions:
- Early postoperative weight gain in infants is due to water and solid tissue accretion.
- Fat accretion is the primary mechanism for energy storage in newly synthesized tissues.
- Findings highlight the importance of nutritional support for body composition recovery.
Abstract:
The purpose of this study was to evaluate the effects of postoperative nutritional management on the body composition of infants after major surgery. We studied 13 full-term surgical infants (mean initial weight 2.88 +/- 0.19 kg; mean days postsurgery 5.0 +/- 0.5). Ten infants were receiving total parenteral nutrition and three were orally fed (mean caloric intake 84 +/- 4 kcal/kg/d; mean fluid intake 145 +/- 4 mL/kg/d). Total body water (TBW) was measured by isotope dilution using heavy oxygen (18O) labeled water (H2(18)O). Total body fat (TBF) was estimated from anthropometric data. Lean body mass (LBM) was calculated as follows: LBM = weight--TBF. Protein, fat, and carbohydrate accretion were determined by energy and macronutrient balance in conjunction with open-circuit indirect calorimetry. Body composition was reevaluated after an interval of seven days. Body weight increased from 2.88 +/- 0.19 to 3.00 +/- 0.19 kg, representing a mean growth velocity of 5.9 g/kg/d. Increments were observed in all body compartments but only the increase in TBF reached statistic significance (12.9 v 14% of body weight, P less than .05). TBW ranged from an initial value of 76.2 +/- 1.4% to a value of 75.5 +/- 1.4% at the end of the study. Protein, fat, and carbohydrate accretion (g/kg/d) during the seven-day study period were 1.62 +/- 0.13; 1.44 +/- 0.41, and 0.96 +/- 0.70, respectively. These data indicate that in the early postoperative period, the weight gain is secondary to both water and solid tissue accretion. Fat represents the major form of energy storage in the new tissues synthesized.(ABSTRACT TRUNCATED AT 250 WORDS)