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Boletín Médico del Hospital Infantil de México

2009, Number 1

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Bol Med Hosp Infant Mex 2009; 66 (1)

Correlation between energy consumption and intake in infants hospitalized in an intensive care unit

Margain-Ojeda MX, López-Alarcón M, Villegas-Silva R, Barbosa-Cortés L, Bernabe-García M, Anaya-Flores S, Madrigal-Muñiz O, Estrada-Flores J

Language: Spanish
References: 20
Page: 41-50
PDF size: 158.97 Kb.


ABSTRACT

Introduction. An adequate feeding is essential in the management of critically ill infants. This study analyzes the association between total energy intake (TEI) and total energy consumption (TEC) of patients hospitalized in a neonatal intensive care unit (NICU) taking into account whether were born preterm (PT), received parenteral nutrition (PN), or underwent surgical treatment (ST).
Methods. A cross-sectional design including 29 patients hospitalized in a NICU after hemodynamic and ventilatory stability was conducted. TEC was determined by indirect calorimetry and TEI by the summation of the energy administered by enteral and parenteral pathways. The statistical analysis included, Spearman correlation, U Mann-Whitney test, exact Fisher test, and multiple regression.
Results. Fourteen patients were born PT, 21 underwent ST; 14 were under PN regime at the moment of the study and 63% were undernourished. TEI was higher in PT (P =0.022), PN (P =0.038), and ST (P =0.046) patients; TEC was greater only in PT infants (P =0.003). TEC correlated with TEI only in patients receiving enteral nutrition (r=0.518, P =046). TEI was inadequate in 85.1% of the patients.
Conclusion. The amount of energy administered to patients hospitalized in the NICU is inadequate when it is estimated by standardized equations. We suggest determining TEC by indirect calorimetry at least in patients under total PN.


REFERENCES

  1. López-Herce J, Sánchez-Sánchez C, Mencía-Bartolomé S, Santiago-Lozano MJ, Carrillo-Álvarez A, Bellón-Cano JM. Consumo calórico en el niño crítico: relación con las características clínicas, el aporte calórico y las fórmulas teóricas de cálculo de las necesidades. An Pediatr. 2007; 66: 229-39.

  2. Villet S, Chiolero RL, Bollmann MD, Revelly JP, Cayeux MC, Delarue J, et al. Negative impact of hypocaloric feeding and energy balance on clinical outcome in ICU patients. Clin Nutr. 2005; 24: 502-9.

  3. Briassoulis G, Tsorva A, Zabras N, Hatzis T. Influence of an aggressive early enteral nutrition protocol on nitrogen balance in critically ill children. J Nutr Biochem. 2002; 13: 560-9.

  4. Garvin CG, Brown RO. Nutritional support in the intensive care unit: Are patients receiving what is prescribed? Crit Care Med. 2001; 29: 204-5.

  5. Coss-Bu JA, Klish WJ, Walding D, Stein F, Smith E, Jefferson LS. Energy metabolism, nitrogen balance, and substrate utilization in critically ill children. Am J Clin Nutr. 2001; 74: 664-9.

  6. Premer DM, Gerogieff MK. Nutrition for Ill Neonates. Pediatr Rev. 1999; 20: 56-62.

  7. Briassoulis G, Venkataraman Sh, Thompson AE. Energy expenditure in critically ill children. Crit Care Med. 2000; 28: 1166-72.

  8. Koletzko B, Goulet O, Hunt J, Krohn K, Shamir R. Guidelines on peadiatric parenteral nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society of Clinical Nutrition and Metabolism (ESPEN), supported by the European Society of Paediatric Research (ESPR). J Pediatr Gastroenterol Nutr. 2005; 41: S1-11.

  9. De Klerk G, Hop WC, de Hoog M, Joosten KF. Serial measurements of energy expenditure in critically ill children: Useful in optimizing nutrition therapy? Intensive Care Med. 2002; 28: 1781-5.

  10. Hulst JM, van Goudoever JB, Zimmermann LJ, Hop WC, Buller HA, Tibboel D, et al. Adequate feeding and the usefulness of the respiratory quotient in critically ill children. Nutrition. 2005; 21: 192-8.

  11. Vázquez-Martínez JL, Martínez-Romillo PD, Diez-Sebastian J, Ruzia-Tarro F. Predicted versus measured energy expenditure by continuous, online indirect calorimetry in ventilated, critically ill children during the early post injury period. Pediatr Crit Care Med. 2004; 5: 19-27.

  12. Habicht JP. Estandarización de métodos epidemiológicos cuantitativos sobre el terreno. Bol Oficina Sanit Panam. 1974; LXXVI: 375-84.

  13. Lubchenco LO, Hansman Ch, Dressler, Boyd E. Intrauterine growth as estimated from live born birth-weight data at 24 to 42 weeks of gestation. Pediatrics. 1963; 32: 793-800.

  14. Consultado el 28 de abril 2008: http://www.cdc.gov/nchs/about/major/nhanes/growthcharts/zscore/zscore.htm

  15. Bronstein MN. Energy requirements and protein energy balance in preterm and term infants. En: Neonatal nutrition and metabolism. St. Louis: Mosby Year Book; 1991. p. 42-70.

  16. Duggan C. Valoración nutricional en niños enfermos u hospitalizados. En: Hendricks KM, Duggan C, Walker WA, editores. Manual de nutrición pediátrica. México: Intersistemas Editores; 2000. p. 179.

  17. Committee on Nutrition, American Academy of Pediatrics. En: Kleinman RE, editor. Pediatric nutrition handbook. Illinois: AAP; 1998. p. 648.

  18. Joosten KF, de Kleijn ED, Westerterp M, de Hoog M, Eijck FC, Hop WCJ, et al. Endocrine and metabolic responses in children with meningococcal sepsis: striking difference between survivors and nonsurvivors. J Clin Endocrinol Metab. 2000; 85: 3746-53.

  19. McClave SA, Lowen CC, Kleber MJ, McConnell JW, Jung LY, Goldsmith LJ. Clinical use of the respiratory quotient obtained from indirect calorimetry. JPEN. 2003; 27: 21-6.

  20. Hulst J, Joosten K, Zimmermann L, Hop W, van Buuren S, Büller H, et al. Malnutrition in critically ill children: From admission to 6 months after discharge. Clin Nutr. 2004; 23: 223-32.




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