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. 1992 Oct;67(10 Spec No):1207–1211. doi: 10.1136/adc.67.10_spec_no.1207

Validation of a portable indirect calorimetry system for measurement of energy expenditure in sick preterm infants.

G J Shortland 1, P J Fleming 1, J H Walter 1
PMCID: PMC1590467  PMID: 1444562

Abstract

A portable indirect calorimeter adapted from adult use was validated for use in preterm infants. Oxygen consumption (VO2) and carbon dioxide production (VCO2) were subsequently measured in 16 preterm infants breathing spontaneously in room air (canopy mode) and in nine preterm infants receiving intermittent positive pressure ventilation (ventilator mode). Validation of the system was performed using a gas injection technique with nitrogen to simulate VO2 and carbon dioxide for VCO2. Mean errors in validation of the canopy mode were 1.4% and 0.2% for VO2 and VCO2 with limits of agreement of 0.6 (+2SD) ml/min and -1.3 (-2SD) ml/min, and 0.9 (+2SD) ml/min and -2.3 (-2SD) ml/min respectively. In validation of the ventilator mode mean errors were -1.8% and -5.05% for VO2 and VCO2 with limits of agreement of 1.02 (+2SD) ml/min and -0.74 (-2SD) ml/min, and 0.93 (+2SD) ml/min and -1.45 (-2SD) ml/min respectively. Values of VO2 and VCO2 in 16 preterm infants in the canopy mode were 6.2 ml/kg/min (0.5 1SD) and 6.7 ml/kg/min (0.6 1SD) and in nine preterm infants in the ventilator mode 4.98 ml/kg/min (1.09 1SD) and 4.74 ml/min/kg (1.08 1SD) respectively. Mean energy expenditure was 45.5 kcal (191 kJ)kg/day for infants measured in the canopy mode and 35.5 kcal (149 kJ)/kg/day for ventilated infants. This metabolic system can be adapted for use in the newborn but accuracy is reduced when it is used in those weighing less than 1000 g.

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Selected References

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  1. Bland J. M., Altman D. G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed] [Google Scholar]
  2. Butte N. F., Smith E. O., Garza C. Energy utilization of breast-fed and formula-fed infants. Am J Clin Nutr. 1990 Mar;51(3):350–358. doi: 10.1093/ajcn/51.3.350. [DOI] [PubMed] [Google Scholar]
  3. Cartlidge P. H., Rutter N. Percutaneous respiration in the newborn infant. Effect of gestation and altered ambient oxygen concentration. Biol Neonate. 1987;52(6):301–306. doi: 10.1159/000242725. [DOI] [PubMed] [Google Scholar]
  4. Chwals W. J., Lally K. P., Woolley M. M., Mahour G. H. Measured energy expenditure in critically ill infants and young children. J Surg Res. 1988 May;44(5):467–472. doi: 10.1016/0022-4804(88)90150-3. [DOI] [PubMed] [Google Scholar]
  5. Dane H. J., Sauer P. J., Visser H. K. Oxygen consumption and CO2 production of low-birth-weight infants in two sleep states. Biol Neonate. 1985;47(4):205–210. doi: 10.1159/000242117. [DOI] [PubMed] [Google Scholar]
  6. Denne S. C., Kalhan S. C. Glucose carbon recycling and oxidation in human newborns. Am J Physiol. 1986 Jul;251(1 Pt 1):E71–E77. doi: 10.1152/ajpendo.1986.251.1.E71. [DOI] [PubMed] [Google Scholar]
  7. Ferrannini E. The theoretical bases of indirect calorimetry: a review. Metabolism. 1988 Mar;37(3):287–301. doi: 10.1016/0026-0495(88)90110-2. [DOI] [PubMed] [Google Scholar]
  8. Halliday D., Rennie M. J. The use of stable isotopes for diagnosis and clinical research. Clin Sci (Lond) 1982 Dec;63(6):485–496. doi: 10.1042/cs0630485. [DOI] [PubMed] [Google Scholar]
  9. Jéquier E., Acheson K., Schutz Y. Assessment of energy expenditure and fuel utilization in man. Annu Rev Nutr. 1987;7:187–208. doi: 10.1146/annurev.nu.07.070187.001155. [DOI] [PubMed] [Google Scholar]
  10. KARLBERG P. [Determinations of standard energy metabolism (basal metabolism) in normal infants]. Acta Paediatr Suppl. 1952 Oct;41(89):1–151. [PubMed] [Google Scholar]
  11. Kalhan S. C., Denne S. C. Energy consumption in infants with bronchopulmonary dysplasia. J Pediatr. 1990 Apr;116(4):662–664. doi: 10.1016/s0022-3476(05)81623-3. [DOI] [PubMed] [Google Scholar]
  12. Lister G., Hoffman J. I., Rudolph A. M. Oxygen uptake in infants and children: a simple method for measurement. Pediatrics. 1974 May;53(5):656–662. [PubMed] [Google Scholar]
  13. Lucas A., Nohria V., Roberts S. B. Measurement of carbon dioxide production rate in sick ventilated premature infants. Biol Neonate. 1987;51(3):138–143. doi: 10.1159/000242644. [DOI] [PubMed] [Google Scholar]
  14. Marks K. H., Coen P., Kerrigan J. R., Francalancia N. A., Nardis E. E., Snider M. T. The accuracy and precision of an open-circuit system to measure oxygen consumption and carbon dioxide production in neonates. Pediatr Res. 1987 Jan;21(1):58–65. doi: 10.1203/00006450-198701000-00014. [DOI] [PubMed] [Google Scholar]
  15. Marks K. H., Nardis E. E., Derr J. A. Day-to-day energy expenditure variability in low birth weight neonates. Pediatr Res. 1987 Jan;21(1):66–71. doi: 10.1203/00006450-198701000-00015. [DOI] [PubMed] [Google Scholar]
  16. Piedboeuf B., Chessex P., Hazan J., Pineault M., Lavoie J. C. Total parenteral nutrition in the newborn infant: energy substrates and respiratory gas exchange. J Pediatr. 1991 Jan;118(1):97–102. doi: 10.1016/s0022-3476(05)81857-8. [DOI] [PubMed] [Google Scholar]
  17. Richardson P., Bose C. L., Bucciarelli R. L., Carlstrom J. R. Oxygen consumption of infants with respiratory distress syndrome. Biol Neonate. 1984;46(2):53–56. doi: 10.1159/000242033. [DOI] [PubMed] [Google Scholar]
  18. Roberts S. B., Murgatroyd P. R., Crisp J. A., Nohria V., Schlingenseipen K. H., Lucas A. Long-term variation in oxygen consumption rate in preterm infants. Biol Neonate. 1987;52(1):1–8. doi: 10.1159/000242677. [DOI] [PubMed] [Google Scholar]
  19. Rubecz I., Mestyán J. Postprandial thermogenesis in human milk-fed very low birth weight infants. Biol Neonate. 1986;49(6):301–306. doi: 10.1159/000324186. [DOI] [PubMed] [Google Scholar]
  20. Simonson D. C., DeFronzo R. A. Indirect calorimetry: methodological and interpretative problems. Am J Physiol. 1990 Mar;258(3 Pt 1):E399–E412. doi: 10.1152/ajpendo.1990.258.3.E399. [DOI] [PubMed] [Google Scholar]
  21. Stothers J. K., Warner R. M. Effect of feeding on neonatal oxygen consumption. Arch Dis Child. 1979 Jun;54(6):415–420. doi: 10.1136/adc.54.6.415. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Yeh T. F., Lilien L. D., Leu S. T., Pildes R. S. Increased O2 consumption and energy loss in premature infants following medical care procedures. Biol Neonate. 1984;46(4):157–162. doi: 10.1159/000242060. [DOI] [PubMed] [Google Scholar]

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