Assuntos
Obstrução das Vias Respiratórias/terapia , Hélio/administração & dosagem , Hipóxia/etiologia , Doenças do Prematuro/terapia , Oxigenoterapia/efeitos adversos , Dióxido de Carbono , Frequência Cardíaca , Humanos , Recém-Nascido , Consumo de Oxigênio , Oxigenoterapia/métodos , Respiração , Traqueotomia , Trabalho RespiratórioRESUMO
With the renewed interest in the feeding of human milk to preterm infants, we have evaluated the partition of energy metabolism and of macronutrient utilization and accretion in growing very low birth weight infants fed their own mother's milk. Fifteen studies combining macronutrient balance, computerized continuous open-circuit indirect calorimetry, and anthropometric measurements were performed in 11 growing, very low birth weight (less than 1.300 gm) preterm infants. The mean milk intake of 172 ml/kg/day provided a gross energy intake of 111 kcal/kg/day. Energy losses in excreta were 11 kcal/kg/day, and the metabolic energy expenditure was 56 kcal/kg/day. The remainder (44 kcal/kg/day) represented the energy stored in the components of new tissue. The infants were gaining weight (15.3 g/kg/day), length (0.98 cm/wk), and head circumference (0.76 cm/wk) at rates approximating intrauterine growth rates. The metabolic energy expenditure was derived from the oxidation (mean +/- SE) of carbohydrate, 9.5 +/- 0.7 gm/kg/day; fat, 1.63 +/- 0.34 gm/kg/day; and protein, 0.68 +/- 0.07 gm/kg/day. The stored energy comprised 2.98 +/- 0.86 gm/kg/day as carbohydrate, 2.25 +/- 0.54 gm/kg/day as fat, and 1.97 +/- 0.1 gm/kg/day as protein. The accretion rates of fat and protein, as well as the composition of the weight gain (fat, 16.6 +/- 4.1%; protein, 13.4 +/- 0.5%), were similar to those reported for the fetus of comparable gestational age.
Assuntos
Crescimento , Recém-Nascido Prematuro , Leite Humano , Antropometria , Peso Corporal , Calorimetria Indireta , Metabolismo Energético , Humanos , Lactente , Recém-Nascido , Necessidades NutricionaisRESUMO
The relative importance and interrelationship of postnatal age, energy intake, and weight gain on metabolic rate is evaluated in 28 studies in 13 formula-fed very low-birth-weight AGA infants. The relationships between metabolic rate, energy intake, weight gain, and age all follow a similar pattern, increasing in the first two weeks of life and subsequently stabilizing. Significant linear correlations are demonstrated between metabolic rate and both energy intake (r = 0.88, P less than 0.001) and weight gain (r = 0.86, P less than 0.001). For each gram of weight gain, 0.67 kcal (2.8 kj) are expended in addition to the maintenance energy requirement of 51 kcal/kg/day. The increase in metabolic rate in the early postnatal period appears to be a consequence of the energy cost of tissue synthesis. Changes in metabolic rate with postnatal age are modulated by increasing energy intake and weight gain.
Assuntos
Peso Corporal , Dieta , Ingestão de Energia , Metabolismo Energético , Recém-Nascido de Baixo Peso , Fatores Etários , Calorimetria Indireta , Humanos , Recém-NascidoRESUMO
A two-year follow-up study of 73 low-birth-weight ( less than 1,501 gm) infants treated with positive pressure ventilation as neonates revealed the following: 24% incidence of lower respiratory tract infections during the first year; weight and height at two years averaging between tenth and twenty-fifth percentiles; major neurologic defects diagnosed in 14 boys (39%) and seven girls (18%) with one-year Bayley scores of less than 80. Major neurologic sequelae were closely associated with a neonatal history of seizures and intracranial hemorrhage and were more common in boys, survivors weighing more than 1,000 gm and following high-risk pregnancies.