Infant body composition assessment in the neonatal intensive care unit (NICU) using air displacement plethysmography: Strategies for implementation into clinical workflow

Alja'nini, Zaineh; Viswanathan, S.; Goddard, Gillian R.; Merlino-Barr, Stephanie; Collin, Marc; Groh-Wargo, Sharon

doi:10.1016/j.clnesp.2021.04.014

Cited by 9 publications

(8 citation statements)

References 94 publications

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“…5,6,13,[18][19][20] Noninvasive body composition assessment using ADP is a validated technique in infants, and many NICUs are using this tool for quality improvement initiatives as well as an objective way of assessing the impact of nutritional interventions in routine NICU clinical practice. 12 Our data reported here on the expected weekly changes in FM and FFM accretion rates and BCAR across the gestational age range of 30-45 weeks' PMA can be a clinically meaningful, readily available practical guide to monitor and compare the quality of postnatal growth and nutrition in NICU infants.…”

Section: Discussionmentioning

confidence: 81%

“…With the availability of safe, reliable, noninvasive infant body composition assessment using air displacement plethysmography (ADP, trade name "PEA POD"-an infant version of the ADP device), body composition assessment is increasingly clinically used to determine the quality of postnatal growth in preterm infants. 12,13 Also, normative, sex-specific reference charts for body composition for the first 6 months of life to monitor growth are now available (Norris body composition charts). 14 To calculate the short-term growth in infants being treated in the NICUs, growth velocity calculated over a defined time period (e.g., weekly) is often used and a weight gain of 15-20 g/kg/day is often considered acceptable.…”

Section: Introductionmentioning

confidence: 99%

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Accretion Rates of Fat and Fat-free Mass in Infants at 30–45 weeks’ Postmenstrual Age

Maheshwari¹,

Viswanathan²,

Aja\'Nini³

et al. 2022

Newborn

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Background: Body composition assessment using noninvasive air displacement plethysmography (ADP) can help determine the quality of postnatal growth in infants. The accretion rates of fat mass (FM) and fat-free mass (FFM), both are known to change in various clinicopathological situations in a discordant fashion, can also help evaluate the short-term impacts of nutritional interventions on body composition. Objectives: To determine the FM and FFM accretion rates from 30 to 45 weeks' postmenstrual age (PMA) and whether these rates are different between male and female infants. Methods: We used previously published normative data with median FM and FFM values for infants at 30-45 weeks' PMA (Norris et al., 2019). Weekly gains in FM and FFM in g/week and g/kg/week were calculated using early one-point and average two-point methods. Results: FM and FFM accretion rates calculated by the early one-point method were higher than the average two-point method. Male and female infants had similar FM and FFM accretion rates. Constant accretion rates of FM and FFM were not aligned with individual weekly accretion rates, which showed a twofold-fourfold change. A composite index (FFM/FM accretion rate ratio), which we named the "body composition accretion ratio" (BCAR), was more sensitive than the individual weekly accretion rates and showed a ninefold change during the study period. Conclusions: Weekly FM and FFM accretion rates can help assess quality of postnatal growth in young infants, but BCAR can be a more useful, sensitive index for early identification of body composition changes and may possibly guide nutritional interventions.

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Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Accretion Rates of Fat and Fat-free Mass in Infants at 30–45 weeks’ Postmenstrual Age

Maheshwari¹,

Viswanathan²,

Aja\'Nini³

et al. 2022

Newborn

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“…17,25 We have recently published the strategies to implement body composition measurements into routine NICU clinical practice. 26 Though serial body composition measurement from birth to NICU discharge may provide more precise information on the quality of tissue accretion over time, many of these infants depend on respiratory support in the early postnatal period which limits the use of ADP technique-based body composition measurement.…”

Section: Discussionmentioning

confidence: 99%

Enhancing Interpretation of One-Time Body Composition Measurement at Near-Term Gestation in Preterm Infants: An Exploratory Study

et al. 2022

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“…Weekly body composition measurement via air displacement plethysmography (ADP) on all eligible surgical patients in the NICU was adopted as routine clinical care in 2017, and is described elsewhere (10). This measurement is used clinically, in addition to other anthropometric and nutritional markers, to trend growth and personalize nutritional care.…”

Section: Methodsmentioning

confidence: 99%

Body Composition of Infants With Congenital Gastroschisis

Poindexter

Goddard

Riddle

et al. 2021

J. pediatr. gastroenterol. nutr.

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Infants born with congenital gastroschisis are at risk for intrauterine growth restriction, small for gestational size at birth, and growth failure during the newborn period despite advanced care. Body composition provides a more complete picture of proportional growth than weight and length alone. Fatfree mass (FFM) represents organ growth, and in preterm infants without gastroschisis, improved FFM deposition is associated with improved neurodevelopmental outcomes. There is limited literature regarding the body composition of infants with gastroschisis. This case series describes the body composition of 10 infants with gastroschisis.

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Infant body composition assessment in the neonatal intensive care unit (NICU) using air displacement plethysmography: Strategies for implementation into clinical workflow

Cited by 9 publications

References 94 publications

Accretion Rates of Fat and Fat-free Mass in Infants at 30–45 weeks’ Postmenstrual Age

Accretion Rates of Fat and Fat-free Mass in Infants at 30–45 weeks’ Postmenstrual Age

Enhancing Interpretation of One-Time Body Composition Measurement at Near-Term Gestation in Preterm Infants: An Exploratory Study

Body Composition of Infants With Congenital Gastroschisis

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