Document Detail

Energy expenditure in ill premature neonates.
MedLine Citation:
PMID:  11877636     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/PURPOSE: The energy needs of critically ill premature neonates undergoing surgery remain to be defined. Results of studies in adults would suggest that these neonates should have markedly increased energy expenditures. To test this hypothesis, a recently validated stable isotopic technique was used to measure accurately the resting energy expenditure (REE) of critically ill premature neonates before and after patent ductus arteriosus (PDA) ligation. METHODS: Six ventilated, fully total parenteral nutrition (TPN)-fed, premature neonates (24.5 plus minus 0.5 weeks' gestational age) were studied at day of life 7.5 plus minus 0.7, immediately before and 16 plus minus 3.7 hours after standard PDA ligation. REE was measured with a primed continuous infusion of NaH(13)CO(3), and breath samples were analyzed by isotope ratio mass spectroscopy. Serum CRP and cortisol concentrations also were obtained. Statistical analyses were made by paired sample t tests and linear regression. RESULTS: The resting energy expenditures pre- and post-PDA ligation were 37.2 plus minus 9.6 and 34.8 plus minus 10.1 kcal/kg/d (not significant, P =.61). Only preoperative energy expenditure significantly (P <.01) predicted postoperative energy expenditure (R(2) = 88.0%). Pre- and postoperative determinations of CRP were 2.1 plus minus 1.5 and 7.1 plus minus 4.2 mg/dL (not significant, P =.34), and cortisol levels were 14.1 plus minus 2.3 and 14.9 plus minus 2.1 microgram/dL (not significant, P =.52). CONCLUSIONS: Thus, critically ill premature neonates do not have elevated REE, and, further, there is no increase in REE evident the first day after surgery. This suggests that routine allotments of excess calories are not necessary either pre-or postoperatively in critically ill premature neonates. Given the high interindividual variability in REE, actual measurement is prudent if protracted nutritional support is required.
Jennifer J Garza; Stephen B Shew; Tamir H Keshen; Alexander Dzakovic; Farook Jahoor; Tom Jaksic
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  37     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-05     Completed Date:  2002-04-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  289-93     Citation Subset:  IM    
Copyright Information:
Copyright 2002 by W.B. Saunders Company.
Department of Surgery, Children's Hospital, Harvard Medical School, Boston, MA, USA.
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MeSH Terms
Carbon Isotopes / blood
Ductus Arteriosus, Patent / metabolism*,  physiopathology,  surgery
Energy Metabolism*
Gestational Age
Hydrocortisone / blood
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / metabolism*,  physiopathology,  surgery
Infusions, Intravenous
Ligation / methods
Postoperative Care
Preoperative Care
Respiration, Artificial / methods
Serum Albumin / metabolism
Sodium Bicarbonate / therapeutic use
Reg. No./Substance:
0/Carbon Isotopes; 0/Serum Albumin; 144-55-8/Sodium Bicarbonate; 50-23-7/Hydrocortisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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