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Resting Energy Expenditure Measured by Indirect Calorimetry in Infants and Young Children with Chronic Lung Disease

Watsamon Jantarabenjakul, Sompol Sanguanrungsirikul, Suchada Sritippayawan, Orapa Suteerojntakool, Sirinuch Chomtho


Objective: To determine resting energy expenditure (REE) by indirect calorimetry and to compare measured resting energy expenditure (mREE) by indirect calorimetry with prediction equations (pREE).

Material and Method: Infants and young children with chronic lung diseases from King Chulalongkorn Memorial Hospital were enrolled and assessed for nutritional status and severity of chronic lung diseases. For mREE, indirect calorimetry was performed by custom-made airtight canopy with O2 and CO2 sensors, with the patients were in a resting state. Prediction equations were Food and Agriculture/World Health Organization/United Nations University (FAO/WHO/UNU), Schofield-Weight, Schofield-Weight/Height, Harris Benedict, and Harris Benedict-Infant equations. Agreement between mREE and pREE was assessed by Bland-Altman method.

Results: Eighteen patients (median age 6 months, range 1 to 26 months) were recruited. Sixteen children had weight for age Z-score below -2 SD. Median weight for age Z-score, length for age Z-score and weight for length Z-score were -3.0, -3.1, and -1.9, respectively. Median mREE was 53.8 kcal/kg/day (interquartile range 47.5 to 72.6 kcal/kg/day). The Schofield-Weight/Height equation showed the lowest mean of difference at 0.94 kcal/kg/day with 95% confidence interval for the bias -44.4 to 46.3 kcal/kg/day.

Conclusion: To ensure optimal nutritional support, REE should be measured by indirect calorimetry in pediatric patients with chronic lung diseases. Based on our finding, the Schofield-Weight/Height equation was the most accurate equation for predicting REE in this group of patients.

Keywords: Resting energy expenditure, Indirect calorimetry, Chronic lung disease, Prediction equations

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