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Measured energy expenditure in mechanically ventilated very low birth weight infants
T D Samiec1, P Radmacher, T Hill
1Department of Pediatrics, University of Louisville, Kentucky 40292.
Insights
Very low birth weight infants with respiratory distress syndrome experienced a caloric deficit during the first four days of mechanical ventilation. Energy expenditure needs were met by the end of the first week.
Area of Science:
- Neonatology
- Pediatric Critical Care
- Nutritional Physiology
Background:
- Respiratory distress syndrome (RDS) is common in very low birth weight (VLBW) infants.
- Mechanical ventilation is a standard treatment for RDS in VLBW infants.
- Accurate assessment of energy expenditure is crucial for optimizing nutritional support in critically ill neonates.
Purpose of the Study:
- To determine the resting energy expenditure (REE) in VLBW infants with RDS on mechanical ventilation.
- To compare energy intake with REE during the first postnatal week.
- To identify potential caloric deficits in this vulnerable population.
Main Methods:
- Forty-nine calorimetric studies were conducted on 24 VLBW infants.
- Infants received mechanical ventilation during the first seven postnatal days.
- Resting energy expenditure and respiratory quotient were measured.
Main Results:
- Mean REE was 59 +/- 21 kcal/kg/day, with significant individual variation.
- Mean respiratory quotient was 0.93 +/- 0.1, indicating carbohydrate metabolism.
- A mean caloric deficit of 31 kcal/kg/day occurred during the first four postnatal days.
- Energy intake met REE during days 5-7 of postnatal life.
Conclusions:
- VLBW infants with RDS on mechanical ventilation experience a significant caloric deficit in the early postnatal period.
- Nutritional strategies may need to address this early deficit to ensure adequate growth and development.
- Wide variations in REE highlight the need for individualized nutritional assessment.
Abstract:
Forty-nine calorimetric studies were performed on 24 very low birth weight infants with respiratory distress syndrome on mechanical ventilation during the first seven postnatal days. Mean resting energy expenditure for the entire study was 59 +/- 21 kilocalories/kg daily, with a respiratory quotient of 0.93 +/- 0.1, reflecting the predominance of carbohydrate calories. A comparison of mean energy intake with mean resting energy expenditure showed a mean caloric deficit of 31 kcal/k daily during the first 4 postnatal days, followed by 3 days where resting energy expenditure was met by equivalent caloric intake. Wide variation was noted in resting energy expenditure.