Abstract
OBJECTIVES—To determine the effect of phototherapy on the oxygen consumption and resting energy expenditure of term and preterm newborn infants. METHODS—A total of 202 infants (gestation 30-42 weeks; body weight 1270-4100 g) requiring phototherapy for the treatment of neonatal hyperbilirubinaemia were enrolled in a randomised crossover study. In random sequence, the oxygen consumption and resting energy expenditure were measured twice in each infant by indirect calorimetry, once at the end of six hours of continuous phototherapy and once after a control period of at least six hours without phototherapy. Anterior abdominal wall temperature was servocontrolled at 36.5°C throughout the study. RESULTS—At the end of six hours of continuous phototherapy, oxygen consumption (mean (SD): 6.21 (1.35) v 6.26 (1.51) ml/kg, p = 0.555) and resting energy expenditure (178.11 (37.62) v 180.37 (43.14) kJ/kg/24 h, p = 0.382) did not differ significantly from those measured after the control period. There were also no significant differences in heart rate, respiratory rate, or rectal temperature. Subgroup analysis of those of gestation < 37 weeks or < 34 weeks also showed no effect of phototherapy on either oxygen consumption or resting energy expenditure. CONCLUSION—Phototherapy has no effect on the metabolic rate of thermally stable term or preterm infants.
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- Baumgart S., Engle W. D., Fox W. W., Polin R. A. Effect of heat shielding on convective and evaporative heat losses and on radiant heat transfer in the premature infant. J Pediatr. 1981 Dec;99(6):948–956. doi: 10.1016/s0022-3476(81)80030-3. [DOI] [PubMed] [Google Scholar]
- Bell E. F., Neidich G. A., Cashore W. J., Oh W. Combined effect of radiant warmer and phototherapy on insensible water loss in low-birth-weight infants. J Pediatr. 1979 May;94(5):810–813. doi: 10.1016/s0022-3476(79)80164-x. [DOI] [PubMed] [Google Scholar]
- Bell E. F., Weinstein M. R., Oh W. Heat balance in premature infants: comparative effects of convectively heated incubator and radiant warmer, with without plastic heat shield. J Pediatr. 1980 Mar;96(3 Pt 1):460–465. doi: 10.1016/s0022-3476(80)80698-6. [DOI] [PubMed] [Google Scholar]
- Darnall R. A., Jr Insensible weight loss measurements in newborn infants: possible overestimation with the Potter baby scale. J Pediatr. 1981 Nov;99(5):794–797. doi: 10.1016/s0022-3476(81)80414-3. [DOI] [PubMed] [Google Scholar]
- Doyle L. W., Sinclair J. C. Insensible water loss in newborn infants. Clin Perinatol. 1982 Oct;9(3):453–482. [PubMed] [Google Scholar]
- Doyle L. W., Sinclair J. C. Temperature changes and the Potter baby scale. J Pediatr. 1982 Jun;100(6):1006–1006. doi: 10.1016/s0022-3476(82)80551-9. [DOI] [PubMed] [Google Scholar]
- Fok T. F., Lam T. K., Lee N., Chow C. B., Au Yeung H. C., Leung N. K., Davies D. P. A prospective study on the intrauterine growth of Hong Kong Chinese babies. Biol Neonate. 1987;51(6):312–323. doi: 10.1159/000242670. [DOI] [PubMed] [Google Scholar]
- Hammarlund K., Nilsson G. E., Oberg P. A., Sedin G. Transepidermal water loss in newborn infants. II. Relation to activity and body temperature. Acta Paediatr Scand. 1979 May;68(3):371–376. doi: 10.1111/j.1651-2227.1979.tb05022.x. [DOI] [PubMed] [Google Scholar]
- Hey E. N., Mount L. E. Heat losses from babies in incubators. Arch Dis Child. 1967 Feb;42(221):75–84. doi: 10.1136/adc.42.221.75. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hey E. N. The relation between environmental temperature and oxygen consumption in the new-born baby. J Physiol. 1969 Feb;200(3):589–603. doi: 10.1113/jphysiol.1969.sp008710. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kjartansson S., Hammarlund K., Riesenfeld T., Sedin G. Respiratory water loss and oxygen consumption in newborn infants during phototherapy. Acta Paediatr. 1992 Oct;81(10):769–773. doi: 10.1111/j.1651-2227.1992.tb12100.x. [DOI] [PubMed] [Google Scholar]
- Kjartansson S., Hammarlund K., Sedin G. Insensible water loss from the skin during phototherapy in term and preterm infants. Acta Paediatr. 1992 Oct;81(10):764–768. doi: 10.1111/j.1651-2227.1992.tb12099.x. [DOI] [PubMed] [Google Scholar]
- Marks K. H., Friedman Z., Maisels M. J. A simple device for reducing insensible water loss in low-birth-weight infants. Pediatrics. 1977 Aug;60(2):223–226. [PubMed] [Google Scholar]
- O W., Yao A. C., Hanson J. S., Lind J. Peripheral circulatory response to phototherapy in newborn infants. Acta Paediatr Scand. 1973 Jan;62(1):49–54. doi: 10.1111/j.1651-2227.1973.tb08064.x. [DOI] [PubMed] [Google Scholar]
- Oh W., Karecki H. Phototherapy and insensible water loss in the newborn infant. Am J Dis Child. 1972 Aug;124(2):230–232. doi: 10.1001/archpedi.1972.02110140080010. [DOI] [PubMed] [Google Scholar]
- Ostrea E. M., Jr, Fleury C. A., Balun J. E., Ting E. C. Accelerated degradation of essential fatty acids as a complication of phototherapy. J Pediatr. 1983 Apr;102(4):617–619. doi: 10.1016/s0022-3476(83)80203-0. [DOI] [PubMed] [Google Scholar]
- Riesenfeld T., Hammarlund K., Jonzon A., Sedin G. Influence of radiant heat stress on respiratory water loss in new-born lambs. Biol Neonate. 1988;53(5):290–294. doi: 10.1159/000242804. [DOI] [PubMed] [Google Scholar]
- Riesenfeld T., Hammarlund K., Sedin G. Respiratory water loss in relation to activity in fullterm infants on their first day after birth. Acta Paediatr Scand. 1987 Nov;76(6):889–893. doi: 10.1111/j.1651-2227.1987.tb17259.x. [DOI] [PubMed] [Google Scholar]
- Riesenfeld T., Hammarlund K., Sedin G. The effect of a warm environment on respiratory water loss in fullterm newborn infants on their first day after birth. Acta Paediatr Scand. 1990 Oct;79(10):893–898. doi: 10.1111/j.1651-2227.1990.tb11349.x. [DOI] [PubMed] [Google Scholar]
- Smales O. R. Effect of phototherapy on thermal environment of the newborn. Arch Dis Child. 1978 Feb;53(2):172–174. doi: 10.1136/adc.53.2.172. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Swenson O., Egan T. J. Measurement of postoperative water requirements in infants. J Pediatr Surg. 1969 Feb;4(1):133–141. doi: 10.1016/0022-3468(69)90194-8. [DOI] [PubMed] [Google Scholar]
- Takala J., Keinänen O., Väisänen P., Kari A. Measurement of gas exchange in intensive care: laboratory and clinical validation of a new device. Crit Care Med. 1989 Oct;17(10):1041–1047. doi: 10.1097/00003246-198910000-00015. [DOI] [PubMed] [Google Scholar]
- Thureen P. J., Phillips R. E., DeMarie M. P., Hoffenberg A., Bronstein M. N., Spedale S. B., Hay W. W., Jr Technical and methodologic considerations for performance of indirect calorimetry in ventilated and nonventilated preterm infants. Crit Care Med. 1997 Jan;25(1):171–180. doi: 10.1097/00003246-199701000-00031. [DOI] [PubMed] [Google Scholar]
- Weyland W., Weyland A., Fritz U., Redecker K., Ensink F. B., Braun U. A new paediatric metabolic monitor. Intensive Care Med. 1994;20(1):51–57. doi: 10.1007/BF02425058. [DOI] [PubMed] [Google Scholar]
- Wu P. Y., Berdahl M. Irradiance in incubators under phototherapy lamps. J Pediatr. 1974 May;84(5):754–755. doi: 10.1016/s0022-3476(74)80026-0. [DOI] [PubMed] [Google Scholar]
- Wu P. Y., Hodgman J. E. Insensible water loss in preterm infants: changes with postnatal development and non-ionizing radiant energy. Pediatrics. 1974 Dec;54(6):704–712. [PubMed] [Google Scholar]
- Wu P. Y., Lim R. C., Hodgman J. E., Kokosky M. J., Teberg A. J. Effect of phototherapy in preterm infants on growth in the neonatal period. J Pediatr. 1974 Oct;85(4):563–566. doi: 10.1016/s0022-3476(74)80471-3. [DOI] [PubMed] [Google Scholar]
- Wu P. Y., Moosa A. Effect of phototherapy on nitrogen and electrolyte levels and water balance in jaundiced preterm infants. Pediatrics. 1978 Feb;61(2):193–198. [PubMed] [Google Scholar]