Resting energy expenditure in children after major surgery

Resting energy expenditure (REE) is reported to increase by 24% in adults following elective operations. We studied REE in 12 children after major surgery to check if they had a similar response. REE was measured by indirect calorimetry. All subjects (6 males, 6 females; age range 6 to 12 years) were measured supine in bed, and after overnight fast. REE was expressed as kilocalories per unit body surface area (BSA) per day. In addition, respiratory quotient (RQ) was calculated for each patient. Contrary to adults, these children did not demonstrate a significant increase in REE following major operative procedures. Furthermore, there was no change in RQ postoperatively. These data demonstrate that children might have a different response to surgical stress than adults. We believe that children are able to convert energy expended on growth to energy spent on wound repair and healing, thus avoiding the overall increase in energy expenditure seen in the adult population.