Skip to main content
Top
Published in: Nutrition & Metabolism 1/2010

Open Access 01-12-2010 | Research

Rest energy expenditure is decreased during the acute as compared to the recovery phase of sepsis in newborns

Authors: Rubens Feferbaum, Cláudio Leone, Arnaldo AF Siqueira, Vitor E Valenti, Paulo R Gallo, Alberto OA Reis, Ary C Lopes, Viviane G Nascimento, Adriana G de Oliveira, Tatiana Dias de Carvalho, Rubens Wajnsztejn, Claudia de Castro Selestrin, Luiz Carlos de Abreu

Published in: Nutrition & Metabolism | Issue 1/2010

Login to get access

Abstract

Background

Little is known with respect to the metabolic response and the requirements of infected newborns. Moreover, the nutritional needs and particularly the energy metabolism of newborns with sepsis are controversial matter. In this investigation we aimed to evaluate the rest energy expenditure (REE) of newborns with bacterial sepsis during the acute and the recovery phases.

Methods

We studied nineteen neonates (27.3 ± 17.2 days old) with bacterial sepsis during the acute phase and recovery of their illness. REE was determined by indirect calorimetry and VO2 and VCO2 measured by gas chromatography.

Results

REE significantly increased from 49.4 ± 13.1 kcal/kg/day during the acute to 68.3 ± 10.9 kcal/kg/day during recovery phase of sepsis (P < 0.01). Similarly, VO2 (7.4 ± 1.9 vs 10 ± 1.5 ml/kg/min) and VCO2 (5.1 ± 1.7 vs 7.4 ± 1.5 ml/kg/min) were also increased during the course of the disease (P < 0.01).

Conclusion

REE was increased during recovery compared to the sepsis phase. REE of septic newborns should be calculated on individualized basis, bearing in mind their metabolic capabilities.
Appendix
Available only for authorised users
Literature
1.
go back to reference Shmerling DH: Development of digestive and absorptive function in the human fetus. Nutr Metab. 1976, 20: 76-9.CrossRef Shmerling DH: Development of digestive and absorptive function in the human fetus. Nutr Metab. 1976, 20: 76-9.CrossRef
2.
go back to reference Ceccon MEJR, Krebs VLJ, Vaz FAC: Sepsis in neonatal period. Pediatr Mod. 2000, 36: 174-9. Ceccon MEJR, Krebs VLJ, Vaz FAC: Sepsis in neonatal period. Pediatr Mod. 2000, 36: 174-9.
3.
go back to reference Hommes FA: The energy requirement for growth. A reevaluation. Nutr Metab. 1980, 24: 110-3. 10.1159/000176330.CrossRef Hommes FA: The energy requirement for growth. A reevaluation. Nutr Metab. 1980, 24: 110-3. 10.1159/000176330.CrossRef
4.
go back to reference Oshikoya KA, Senbanjo IO: Pathophysiological changes that affect drug disposition in protein-energy malnourished children. Nutr Metab. 2009, 6: 50-10.1186/1743-7075-6-50.CrossRef Oshikoya KA, Senbanjo IO: Pathophysiological changes that affect drug disposition in protein-energy malnourished children. Nutr Metab. 2009, 6: 50-10.1186/1743-7075-6-50.CrossRef
5.
go back to reference Bauer J, Werner C, Gerss J: Metabolic rate analysis of healthy preterm and full-term infants during the first weeks of life. Am J Clin Nutr. 2009, 90: 1517-24. 10.3945/ajcn.2009.28304.CrossRef Bauer J, Werner C, Gerss J: Metabolic rate analysis of healthy preterm and full-term infants during the first weeks of life. Am J Clin Nutr. 2009, 90: 1517-24. 10.3945/ajcn.2009.28304.CrossRef
6.
go back to reference Bauer J, Teufel U, Maser-Gluth C, Doege C: Effects of budesonide inhalation on energy expenditure, somatic growth and salivary cortisol levels in preterm infants with chronic lung disease. Horm Res. 2009, 72: 146-52. 10.1159/000232488.CrossRef Bauer J, Teufel U, Maser-Gluth C, Doege C: Effects of budesonide inhalation on energy expenditure, somatic growth and salivary cortisol levels in preterm infants with chronic lung disease. Horm Res. 2009, 72: 146-52. 10.1159/000232488.CrossRef
7.
go back to reference McHoney M, Eaton S, Pierro A: Metabolic response to surgery in infants and children. Eur J Pediatr Surg. 2009, 19: 275-85. 10.1055/s-0029-1241192.CrossRef McHoney M, Eaton S, Pierro A: Metabolic response to surgery in infants and children. Eur J Pediatr Surg. 2009, 19: 275-85. 10.1055/s-0029-1241192.CrossRef
8.
go back to reference Pierro A, Eaton S: Metabolism and nutrition in the surgical neonate. Semin Pediatr Surg. 2008, 17: 276-84. 10.1053/j.sempedsurg.2008.07.006.CrossRef Pierro A, Eaton S: Metabolism and nutrition in the surgical neonate. Semin Pediatr Surg. 2008, 17: 276-84. 10.1053/j.sempedsurg.2008.07.006.CrossRef
9.
go back to reference Cañete A, Duggan C: Nutritional support of the pediatric intensive care unit patient. Curr Opin Pediatr. 1996, 8: 248-55. 10.1097/00008480-199606000-00011.CrossRef Cañete A, Duggan C: Nutritional support of the pediatric intensive care unit patient. Curr Opin Pediatr. 1996, 8: 248-55. 10.1097/00008480-199606000-00011.CrossRef
10.
go back to reference Jüttner B, Kröplin J, Coldewey SM, Witt L, Osthaus WA, Weilbach C, Scheinichen : Unsaturated long-chain fatty acids induce the respiratory burst of human neutrophils and monocytes in whole blood. Nutr Metab. 2008, 5: 19-10.1186/1743-7075-5-19.CrossRef Jüttner B, Kröplin J, Coldewey SM, Witt L, Osthaus WA, Weilbach C, Scheinichen : Unsaturated long-chain fatty acids induce the respiratory burst of human neutrophils and monocytes in whole blood. Nutr Metab. 2008, 5: 19-10.1186/1743-7075-5-19.CrossRef
11.
12.
go back to reference Jaye DL, Waites KB: Clinical applications of C-reactive protein in pediatrics. Pediatr Infect Dis J. 1997, 16: 735-47. 10.1097/00006454-199708000-00003.CrossRef Jaye DL, Waites KB: Clinical applications of C-reactive protein in pediatrics. Pediatr Infect Dis J. 1997, 16: 735-47. 10.1097/00006454-199708000-00003.CrossRef
13.
go back to reference Fehling C, Jägerstad M: Vitamin B12 deprivation in the rat: effects on folate metabolism with emphasis on the nervous system. Nutr Metab. 1978, 22: 90-100. 10.1159/000176202.CrossRef Fehling C, Jägerstad M: Vitamin B12 deprivation in the rat: effects on folate metabolism with emphasis on the nervous system. Nutr Metab. 1978, 22: 90-100. 10.1159/000176202.CrossRef
14.
go back to reference Feferbaum R: Parenteral nutrition in newborn with prolonged diarrhea. 1983, São Paulo; MSc - Faculdade de Medicina da Universidade de São Paulo Feferbaum R: Parenteral nutrition in newborn with prolonged diarrhea. 1983, São Paulo; MSc - Faculdade de Medicina da Universidade de São Paulo
15.
go back to reference Capurro H, Konichezky S, Fonseca D, Caldeyro-Barcia R: A: Simplified method for diagnostic of gestacional age in the newborn infant. J Pediatr. 1978, 93: 102-12. 10.1016/S0022-3476(78)80615-5.CrossRef Capurro H, Konichezky S, Fonseca D, Caldeyro-Barcia R: A: Simplified method for diagnostic of gestacional age in the newborn infant. J Pediatr. 1978, 93: 102-12. 10.1016/S0022-3476(78)80615-5.CrossRef
16.
go back to reference Ramos JLA: Evaluation of intra-uterin growth by anthropometric measurement in newborns. 1983, São Paulo; PhD - Faculdade de Medicina da Universidade de São Paulo Ramos JLA: Evaluation of intra-uterin growth by anthropometric measurement in newborns. 1983, São Paulo; PhD - Faculdade de Medicina da Universidade de São Paulo
17.
go back to reference Cardoso AL, Carraza FR, Mariano MA, Gomes C, Saraiva PAP: Energy balance during malnourished newborns with diarrhea hospitalization. Rev Paul Pediatr. 1991, 9: 142-6. Cardoso AL, Carraza FR, Mariano MA, Gomes C, Saraiva PAP: Energy balance during malnourished newborns with diarrhea hospitalization. Rev Paul Pediatr. 1991, 9: 142-6.
18.
go back to reference Bauer K, Pasel K, Uhrig C, Sperling P, Versdmold H: Comparison of face mask, head hood, and canopy for breath sampling of flow through indirect calorimetry to measure oxygen consumption and carbon monoxide production of preterm infants less than 1500 grams. Pediatr Res. 1997, 41: 139-144. 10.1203/00006450-199701000-00022.CrossRef Bauer K, Pasel K, Uhrig C, Sperling P, Versdmold H: Comparison of face mask, head hood, and canopy for breath sampling of flow through indirect calorimetry to measure oxygen consumption and carbon monoxide production of preterm infants less than 1500 grams. Pediatr Res. 1997, 41: 139-144. 10.1203/00006450-199701000-00022.CrossRef
19.
go back to reference Hamamoto LA, Cardoso AL, Marques HH, Gomes C: Energy balance in infants born from HIV seropositive mothers. J Pediatr. 2000, 76: 119-24.CrossRef Hamamoto LA, Cardoso AL, Marques HH, Gomes C: Energy balance in infants born from HIV seropositive mothers. J Pediatr. 2000, 76: 119-24.CrossRef
20.
go back to reference Scopes JW, Ahmed I: Range of critical temperatures in sick and newborn babies. Arch Dis Child. 1966, 41: 417-10.1136/adc.41.218.417.CrossRef Scopes JW, Ahmed I: Range of critical temperatures in sick and newborn babies. Arch Dis Child. 1966, 41: 417-10.1136/adc.41.218.417.CrossRef
21.
go back to reference Li J, Zhang G, Herridge J, Holtby H, Humpl T, Redington AN, Van Arsdell GS: Energy expenditure and caloric and protein intake in infants following the Norwood procedure. Pediatr Crit Care Med. 2008, 9: 55-61. 10.1097/01.PCC.0000298756.82286.23.CrossRef Li J, Zhang G, Herridge J, Holtby H, Humpl T, Redington AN, Van Arsdell GS: Energy expenditure and caloric and protein intake in infants following the Norwood procedure. Pediatr Crit Care Med. 2008, 9: 55-61. 10.1097/01.PCC.0000298756.82286.23.CrossRef
22.
go back to reference Long CL, Schaffel N, Geiger JW: Metabolic response to injury and illness: estimation of energy and protein needs from indirect calorimetry and nitrogen balance. J Parent Enteral Nutr. 1979, 3: 452-10.1177/0148607179003006452.CrossRef Long CL, Schaffel N, Geiger JW: Metabolic response to injury and illness: estimation of energy and protein needs from indirect calorimetry and nitrogen balance. J Parent Enteral Nutr. 1979, 3: 452-10.1177/0148607179003006452.CrossRef
23.
go back to reference O'Riordan CF, Metcalf BS, Perkins JM, Wilkin TJ: Reliability of energy expenditure prediction equations in the weight management clinic. J Hum Nutr Diet. 2010, 23: 169-75. 10.1111/j.1365-277X.2009.01032.x.CrossRef O'Riordan CF, Metcalf BS, Perkins JM, Wilkin TJ: Reliability of energy expenditure prediction equations in the weight management clinic. J Hum Nutr Diet. 2010, 23: 169-75. 10.1111/j.1365-277X.2009.01032.x.CrossRef
24.
go back to reference Wahlig TM, Georgieff MK: The effects of illness on neonatal metabolism and nutritional management. Clin Perinatol. 1995, 33: 77-96. Wahlig TM, Georgieff MK: The effects of illness on neonatal metabolism and nutritional management. Clin Perinatol. 1995, 33: 77-96.
25.
go back to reference Briassoulis G, Venkataraman S, Thompson AE: Energy expenditure in critically ill children. Crit Care Med. 2000, 28: 166-72. 10.1097/00003246-200004000-00042.CrossRef Briassoulis G, Venkataraman S, Thompson AE: Energy expenditure in critically ill children. Crit Care Med. 2000, 28: 166-72. 10.1097/00003246-200004000-00042.CrossRef
26.
go back to reference Coss-Bu JA, Jefferson LS, Walding D, David Y, Smith EO, Klish WJ: Resting energy expenditure and nitrogen balance in critically ill pediatric patients on mechanical ventilation. Nutrition. 1988, 14: 649-52. 10.1016/S0899-9007(98)00050-1.CrossRef Coss-Bu JA, Jefferson LS, Walding D, David Y, Smith EO, Klish WJ: Resting energy expenditure and nitrogen balance in critically ill pediatric patients on mechanical ventilation. Nutrition. 1988, 14: 649-52. 10.1016/S0899-9007(98)00050-1.CrossRef
27.
go back to reference Powis MR, Smith K, Rennie M, Halliday D, Pierro A: Effect of major abdominal operations on energy and protein metabolism in infants and children. J Pediatr Surg. 1998, 33: 49-53. 10.1016/S0022-3468(98)90360-8.CrossRef Powis MR, Smith K, Rennie M, Halliday D, Pierro A: Effect of major abdominal operations on energy and protein metabolism in infants and children. J Pediatr Surg. 1998, 33: 49-53. 10.1016/S0022-3468(98)90360-8.CrossRef
28.
go back to reference Chwals WJ, Lally KP, Woolley MM: Measured energy expenditure in critically ill infants and young children. J Surg Res. 1988, 44: 467-72. 10.1016/0022-4804(88)90150-3.CrossRef Chwals WJ, Lally KP, Woolley MM: Measured energy expenditure in critically ill infants and young children. J Surg Res. 1988, 44: 467-72. 10.1016/0022-4804(88)90150-3.CrossRef
29.
go back to reference Pencharz PB: A new approach to measure energy expenditure in the neonate. Pediatr Res. 2000, 47: 707-8. 10.1203/00006450-200006000-00004.CrossRef Pencharz PB: A new approach to measure energy expenditure in the neonate. Pediatr Res. 2000, 47: 707-8. 10.1203/00006450-200006000-00004.CrossRef
30.
go back to reference Uzel N, Neyzi O: Thyroid function in critically ill infants with infections. Pediatr Infect Dis J. 1986, 5: 516-9. 10.1097/00006454-198609000-00005.CrossRef Uzel N, Neyzi O: Thyroid function in critically ill infants with infections. Pediatr Infect Dis J. 1986, 5: 516-9. 10.1097/00006454-198609000-00005.CrossRef
31.
go back to reference Mendoza-Morfín F, Vaca-Arellano MR, Toledo-Villalpando AD, Olvera-Hidalgo C, Mondragón-Rosales L, Junco-Lorenzana E: The quantitative analysis of thyroid hormones and thyrotropin in children critically ill with septicemia. Bol Med Hosp Infant Mex. 1991, 48: 230-4. Mendoza-Morfín F, Vaca-Arellano MR, Toledo-Villalpando AD, Olvera-Hidalgo C, Mondragón-Rosales L, Junco-Lorenzana E: The quantitative analysis of thyroid hormones and thyrotropin in children critically ill with septicemia. Bol Med Hosp Infant Mex. 1991, 48: 230-4.
32.
go back to reference Hatherill M, Tibby SM, Hilliard T, Turner C, Murdoch IA: Adrenal insufficiency in septic shock. Arch Dis Child. 1999, 80: 51-5. 10.1136/adc.80.1.51.CrossRef Hatherill M, Tibby SM, Hilliard T, Turner C, Murdoch IA: Adrenal insufficiency in septic shock. Arch Dis Child. 1999, 80: 51-5. 10.1136/adc.80.1.51.CrossRef
33.
go back to reference Togari H, Sugiyama S, Ogino T, Suzuki S, Ito T, Ichiki T, Kamiya K, Watanabe I, Ogawa Y, Wada Y: Interactions of endotoxin with cortisol and acute phase proteins in septic shock. Acta Paediatr Scand. 1986, 75: 69-74. 10.1111/j.1651-2227.1986.tb10159.x.CrossRef Togari H, Sugiyama S, Ogino T, Suzuki S, Ito T, Ichiki T, Kamiya K, Watanabe I, Ogawa Y, Wada Y: Interactions of endotoxin with cortisol and acute phase proteins in septic shock. Acta Paediatr Scand. 1986, 75: 69-74. 10.1111/j.1651-2227.1986.tb10159.x.CrossRef
34.
go back to reference Fusch C, Bauer K, Böhles HJ, Jochum F, Koletzko B, Krawinkel M, Krohn K, Mühlebach S, Working group for developing the guidelines for parenteral nutrition of The German Society for Nutritional Medicine: Neonatology/Paediatrics - Guidelines on Parenteral Nutrition, Chapter 13. Ger Med Sci. 2009, 7: NDoc15 Fusch C, Bauer K, Böhles HJ, Jochum F, Koletzko B, Krawinkel M, Krohn K, Mühlebach S, Working group for developing the guidelines for parenteral nutrition of The German Society for Nutritional Medicine: Neonatology/Paediatrics - Guidelines on Parenteral Nutrition, Chapter 13. Ger Med Sci. 2009, 7: NDoc15
35.
go back to reference Ista E, Joosten K: utritional assessment and enteral support of critically ill children. Crit Care Nurs Clin North Am. 2005, 17: N385-93. 10.1016/j.ccell.2005.07.011.CrossRef Ista E, Joosten K: utritional assessment and enteral support of critically ill children. Crit Care Nurs Clin North Am. 2005, 17: N385-93. 10.1016/j.ccell.2005.07.011.CrossRef
36.
go back to reference Kreymann G, Grosser S, Buggisch P, Gottschall C, Matthaei S, Greten H: Oxygen consumption and resting metabolic rate in sepsis, sepsis syndrome, and septic shock. Crit Care Med. 1993, 21: 1012-9. 10.1097/00003246-199307000-00015.CrossRef Kreymann G, Grosser S, Buggisch P, Gottschall C, Matthaei S, Greten H: Oxygen consumption and resting metabolic rate in sepsis, sepsis syndrome, and septic shock. Crit Care Med. 1993, 21: 1012-9. 10.1097/00003246-199307000-00015.CrossRef
Metadata
Title
Rest energy expenditure is decreased during the acute as compared to the recovery phase of sepsis in newborns
Authors
Rubens Feferbaum
Cláudio Leone
Arnaldo AF Siqueira
Vitor E Valenti
Paulo R Gallo
Alberto OA Reis
Ary C Lopes
Viviane G Nascimento
Adriana G de Oliveira
Tatiana Dias de Carvalho
Rubens Wajnsztejn
Claudia de Castro Selestrin
Luiz Carlos de Abreu
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Nutrition & Metabolism / Issue 1/2010
Electronic ISSN: 1743-7075
DOI
https://doi.org/10.1186/1743-7075-7-63

Other articles of this Issue 1/2010

Nutrition & Metabolism 1/2010 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.