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10.1097/MPG.0000000000000288

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C5025756!5025756!24361903
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suck abstract from ncbi


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pmid24361903      J+Pediatr+Gastroenterol+Nutr 2014 ; 58 (5): 637-41
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  • Variability of Resting Energy Expenditure in Infants and Young Children with Intestinal Failure-Associated Liver Disease #MMPMID24361903
  • Duro D; Mitchell PD; Mehta NM; Bechard LJ; Yu YM; Jaksic T; Duggan C
  • J Pediatr Gastroenterol Nutr 2014[May]; 58 (5): 637-41 PMID24361903show ga
  • Objective: To determine, in a cohort of young children with intestinal failure (IF), if estimates of basal metabolic rate (BMR) by standard equations, approximate measured REE by indirect calorimetry (IC). Methods: IC was performed by dilutional canopy technique. REE measurements were compared to standard, age-based estimation equations (WHO) for BMR. Subjects were classified as hypermetabolic (REE > 110% BMR), hypometabolic (REE < 90% BMR), or normal (REE = 90?110% BMR). Results: Twenty-eight IF patients (11 female, 17 male) had an underlying diagnosis of necrotizing enterocolitis (n=10) or a congenital gastrointestinal defect (n=18). Median age was 5.3 months. Median (IQR) REE was 46 (42, 58) kcal/kg/day. Median (IQR) total energy intake provided 209 (172, 257)% of REE, with parenteral nutrition providing 76% (23%) of total energy intake. REE was variable, with 39% (n=11) of measurements hypermetabolic, 39% (n=11) hypometabolic, and the remaining 21% (n=6) normal. Although REE was well correlated with estimated BMR (r = 0.82, P < 0.0001), estimated BMR was not consistently an adequate predictor of REE. BMR over- or under-estimated REE by more than 10 kcal/kg/d in 15/28 (54%) patients. REE was not significantly correlated with severity of liver disease, nutritional status, total energy intake or gestational age. Conclusions: Energy expenditure is variable among children with IF and IFALD, with nearly 80% of our cohort exhibiting either hypo- or hypermetabolism. Standard estimation equations frequently do not correctly predict individual REE. Longitudinal studies of energy expenditure and body composition may be needed to guide provision of nutrition regimens.
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