Relative hypermetabolism in infants with heart disease and undernutrition

Lees, Martin H.; Bristow, James; Griswold, Herbert E.; Olmsted, Richard W.

doi:10.1016/s0022-3476(65)81819-4

Cited by 25 publications

(39 citation statements)

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“…Increased REE has been previously reported in infants and children with CHD and is thought to reflect the increased energy demands of hypertrophied cardiac muscle, respiratory muscles, the sympathetic nervous system and hematopoietic tissue (Pittman and Cohen, 1964;Lees et al, 1965). This study not only confirms increased REE in infants with CHD, but extends these findings by observing that increased REE normalizes within a week of corrective cardiac surgery.…”

Section: Discussionsupporting

confidence: 85%

Changes in resting energy expenditure in children with congenital heart disease

et al. 2007

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Objectives: The aim of this study was to relate changes in energy expenditure and growth in infants with congenital heart disease (CHD), to the timing of corrective cardiac surgery. Methods: Prospective cohort study of infants less than 1 year with CHD admitted for cardiac surgery to Royal Children's Hospital, between January to September 2005. Infants were assessed using anthropometry and indirect calorimetry and compared to healthy age-matched controls. Results: Infants (38) underwent corrective (n ¼ 25) or palliative (n ¼ 13) cardiac surgery either at p10 days or at 410 days. Infants undergoing corrective surgery after 10 days had deficits in z-scores for weight compared with infants undergoing early surgery (À1.15 ± 1.02 vs À0.24 ± 0.98; CI 95%: À1.736 to À0.085; Po0.05) and height (À1.47 ± 1.16 vs À0.12 ± 0.66; CI 95%: À2.262 to À0.428; Po0.01). However, 6 months following surgery, weight and height were similar in both groups. Resting energy expenditure was increased before surgery compared to healthy controls (247 ± 36 vs 210 ± 22 kJ kg À1 day À1 ; 95% CI: À57.29 to À16.71; Po0.001) however, normalized 1 week following cardiac surgery. Standard equations did not accurately predict measured REE. Conclusion: Increased REE observed in infants with CHD normalizes within 1 week following corrective cardiac surgery. Deficits in weight and growth were greater in infants undergoing corrective cardiac surgery410 days of age compared with infants undergoing surgery in the first 10 days of life.

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Section: Discussionsupporting

confidence: 85%

Changes in resting energy expenditure in children with congenital heart disease

et al. 2007

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“…This procedure would be unsatisfactory for Moreover, normal serum albumin and prealbumin values indicated that the protein nutritional status of all infants was adequate . Our findings do not confirm previous studies which suggested that low food intake was the main cause of inadequate weight gain and of small subcutaneous fat stores in infants with CHD [11,13,15,16,25,26,29] . However, their nutritional requirements may be greater than those of healthy infants because increased oxygen consumption has been demonstrated [16,17,28] .…”

contrasting

confidence: 99%

“…Listed among the possible causes of growth failure have been reduced peripheral blood flow with tissue hypoxia and acidosis [1,4,8], repeated respiratory infections [3,20], and pulmonary hypertension [2,7,20] . Infants may be hypermetabolic [14,16,24] or exhibit gastrointestinal absorptive defects [15,21,23,27] . Thus, energy requirements of infants with CHD are probably greater than those of normal infants .…”

mentioning

confidence: 99%

Growth and nutritional intake of infants with congenital heart disease

et al. 1989

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Poor weight and length gain of infants with congenital heart disease is generally considered to be related to inadequate nutritional intake, but no longitudinal data on growth and nutritional intake of such infants are available. We compared weight, length, subscapular and triceps skinfold thickness, energy and protein intake (24-h dietary intake records) as well as serum prealbumin and albumin of infants with cyanotic heart disease (n = 8) or isolated left-to-right shunt (n = 8) with those of healthy infants aged (n = 8) 45-365 days. Weight, length, and combined (subscapular and triceps) skinfold thickness of the two groups with congenital heart disease (CHD) were significantly less from 183 through 365 days of age. However, energy and protein intake was similar to that of the control group from 45 through 365 days of age. Normal serum prealbumin and albumin in the infants with CHD ruled out protein-calorie malnutrition. It is concluded that a low level of food intake was not the main cause of inadequate growth and of small subcutaneous fat stores in these two small, but homogeneous, groups of infants with CHD.

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“…Early investigations into growth failure in infants with CHD centered on the idea of a "hypermetabolic" state and measured resting energy expenditure (REE) via indirect calorimetry in an attempt to explain the observed failure-to-thrive (FTT) with mixed results (Huse, Feldt, Nelson, & Novak, 1975;Krauss & Auld, 1975;Krieger, 1970;Lees, Bristow, Griswold, & Olmsted, 1965). Lees et al (1965) observed a higher mean oxygen consumption in infants with CHD compared to healthy controls, however, this difference appeared to be related to nutritional status as those whose weight was greater than 60% of the median weight-for-age had a mean oxygen consumption similar to healthy controls. Comparing infants with CHD to a control group of infants with growth failure in the absence of organic disease resulted in no significant difference in basal metabolic rate (BMR) and oxygen consumption (Krieger, 1970).…”

mentioning

confidence: 99%

“…These findings led some researchers to suggest that the growth failure was result of a combination of factors which may include inadequate nutritional intake and gastrointestinal malabsorption (Huse et al, 1975;Krieger, 1970;Lees et al, 1965). Infants with CHD were reported to have growth failure due to inadequate calorie intake to meet their energy requirements (Huse et al, 1975;Mennon & Poskitt, 1986).…”

mentioning

confidence: 99%

Defining Fluid Restriction in the Management of Infants Following Cardiac Surgery and Understanding the Subsequent Impact on Nutrient Delivery and Growth Outcomes

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Relative hypermetabolism in infants with heart disease and undernutrition

Cited by 25 publications

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Changes in resting energy expenditure in children with congenital heart disease

Changes in resting energy expenditure in children with congenital heart disease

Growth and nutritional intake of infants with congenital heart disease

Defining Fluid Restriction in the Management of Infants Following Cardiac Surgery and Understanding the Subsequent Impact on Nutrient Delivery and Growth Outcomes

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