OBJECTIVES: To determine pre- and postoperative predictors of energy expenditure in children with congenital heart disease requiring open heart surgery; and to compare measured resting energy expenditure with current predictive equations. DESIGN: Prospective resting energy expenditure data were collected, using indirect calorimetry, for ventilated children admitted consecutively to the pediatric intensive care unit after surgery for congenital heart disease. A 30-min steady-state measurement was performed in suitable patients. Resting energy expenditure was compared to pre- and postoperative clinical variables, and to predicted energy expenditure, using currently used predictive equations. SETTING: Pediatric intensive care unit at the Royal Brompton Hospital, London. PATIENTS: Children ventilated in the pediatric intensive care unit post surgery for congenital heart disease. INTERVENTIONS: Measurement of energy expenditure by indirect calorimetry. MEASUREMENTS AND MAIN RESULTS: Twenty-one mechanically ventilated children (n = 17 boys, 4 girls) were enrolled in the study. Mean +/- sd measured resting energy expenditure was 67.8 +/- 15.4 kcal/kg/day. Most children had inadequate delivery of nutrients compared with actual requirements. Cardiopulmonary bypass had a significant influence on energy expenditure after surgery; in patients who underwent cardiopulmonary bypass during surgery, mean resting energy expenditure was 73.6 +/- 14.45 kcal/kg/day vs. 58.3 +/- 10.29 kcal/kg/day in patients undergoing nonbypass surgery. Children who were malnourished preoperatively had greater resting energy expenditure postoperatively. There was also a significant difference between measured energy expenditure and the Schofield (p = .006), World Health Organization (p = .002), and pediatric intensive care unit-specific formula (p < .0001). However, energy expenditure or a relative energy deficit in the early postoperative period was not associated with severity or duration of organ dysfunction. CONCLUSIONS: Poor nutritional status preoperatively and cardiopulmonary bypass were associated with a greater energy expenditure post cardiac surgery. None of the current predictive equations predicted energy requirements within acceptable clinical accuracy.
OBJECTIVES: To determine pre- and postoperative predictors of energy expenditure in children with congenital heart disease requiring open heart surgery; and to compare measured resting energy expenditure with current predictive equations. DESIGN: Prospective resting energy expenditure data were collected, using indirect calorimetry, for ventilated children admitted consecutively to the pediatric intensive care unit after surgery for congenital heart disease. A 30-min steady-state measurement was performed in suitable patients. Resting energy expenditure was compared to pre- and postoperative clinical variables, and to predicted energy expenditure, using currently used predictive equations. SETTING: Pediatric intensive care unit at the Royal Brompton Hospital, London. PATIENTS: Children ventilated in the pediatric intensive care unit post surgery for congenital heart disease. INTERVENTIONS: Measurement of energy expenditure by indirect calorimetry. MEASUREMENTS AND MAIN RESULTS: Twenty-one mechanically ventilated children (n = 17 boys, 4 girls) were enrolled in the study. Mean +/- sd measured resting energy expenditure was 67.8 +/- 15.4 kcal/kg/day. Most children had inadequate delivery of nutrients compared with actual requirements. Cardiopulmonary bypass had a significant influence on energy expenditure after surgery; in patients who underwent cardiopulmonary bypass during surgery, mean resting energy expenditure was 73.6 +/- 14.45 kcal/kg/day vs. 58.3 +/- 10.29 kcal/kg/day in patients undergoing nonbypass surgery. Children who were malnourished preoperatively had greater resting energy expenditure postoperatively. There was also a significant difference between measured energy expenditure and the Schofield (p = .006), World Health Organization (p = .002), and pediatric intensive care unit-specific formula (p < .0001). However, energy expenditure or a relative energy deficit in the early postoperative period was not associated with severity or duration of organ dysfunction. CONCLUSIONS: Poor nutritional status preoperatively and cardiopulmonary bypass were associated with a greater energy expenditure post cardiac surgery. None of the current predictive equations predicted energy requirements within acceptable clinical accuracy.
Authors: Nilesh M Mehta; John M Costello; Lori J Bechard; Victor M Johnson; David Zurakowski; Francis X McGowan; Peter C Laussen; Christopher P Duggan Journal: JPEN J Parenter Enteral Nutr Date: 2012-04-26 Impact factor: 4.016
Authors: Lyvonne N Tume; Frederic V Valla; Koen Joosten; Corinne Jotterand Chaparro; Lynne Latten; Luise V Marino; Isobel Macleod; Clémence Moullet; Nazima Pathan; Shancy Rooze; Joost van Rosmalen; Sascha C A T Verbruggen Journal: Intensive Care Med Date: 2020-02-20 Impact factor: 17.440
Authors: Sharon Y Irving; Barbara Medoff-Cooper; Nicole O Stouffer; Joan I Schall; Chitra Ravishankar; Charlene W Compher; Bradley S Marino; Virginia A Stallings Journal: Congenit Heart Dis Date: 2013-01-30 Impact factor: 2.007