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Total energy expenditure in infants with bronchopulmonary dysplasia is associated with respiratory status
K de Meer1, K R Westerterp, R H Houwen
1University Children's Hospital Het Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands.
Insights
Infants with bronchopulmonary dysplasia (BPD) have higher energy expenditure, significantly linked to their respiratory rate. This finding is crucial for managing nutrition in infants with severe BPD.
Area of Science:
- Pediatrics
- Neonatology
- Respiratory Medicine
Background:
- Growth failure is a common issue in infants diagnosed with bronchopulmonary dysplasia (BPD).
- Understanding energy expenditure is key to managing nutritional needs in these vulnerable infants.
Purpose of the Study:
- To investigate the total daily energy expenditure (Ee) in preterm infants with BPD.
- To analyze the relationship between energy expenditure, nutritional balance, growth, and clinical status, particularly respiratory function.
Main Methods:
- Utilized the doubly labeled water technique to measure Ee over a 6-day period in preterm infants with BPD and matched controls.
- Assessed energy and protein balance, growth parameters, and respiratory status (respiratory frequency).
Main Results:
- Infants with BPD exhibited significantly higher Ee compared to controls (73 vs. 63 kcal/kg/day).
- Elevated respiratory frequency in BPD infants was the primary determinant of their increased Ee (r² = 0.82, P < 0.001).
- No significant differences were observed in weight gain, energy intake, energy cost of growth, protein retention, or physical activity between groups.
Conclusions:
- Total energy expenditure is elevated in infants with BPD and is strongly correlated with their respiratory status.
- These findings offer practical insights for optimizing nutritional support strategies in infants suffering from severe BPD.
Unlabelled:
Growth failure is a well-known problem in infants with bronchopulmonary dysplasia (BPD). We studied BPD infants' total daily energy expenditure (Ee), nutritional balance, and growth in relation to their past and current clinical status. Applying the doubly labelled water technique, Ee was measured in nine preterm infants with BPD receiving supplemental oxygen (postnatal age 61 +/- 13 days) and nine matched controls (36 +/- 21 days) during a 6-day period. Energy and protein balance, past and present respiratory status, and growth were assessed as well. The results show that Ee was higher in the BPD infants compared to controls (73 +/- 9 vs 63 +/- 8 kcal/kg/day, P < 0.05), but their faecal energy loss was lower (P < 0.01). Weight gain, energy intake, energy cost of growth, protein retention, and physical activity were not different. The respiratory frequency (RR) in the BPD infants was elevated in comparison with controls (P < 0.01). Within the BPD group, RR was positively correlated with energy expenditure (regression equation: Ee [kcal/kg/day] = 26.3 + 0.71*RR [min-1]; r2 = 0.82, P < 0.001), and was the single most significant determinant of Ee.
Conclusion:
Total energy expenditure in BPD infants is elevated and is strongly associated with their respiratory status. These findings could be of practical value for the nutritional management in infants with severe BPD.