Francesca Penagini1, Barbara Borsani2, Alessandra Bosetti2, Chiara Mameli3, Dario Dilillo3, Giulia Ramponi3, Francesco Motta4, Giorgio Bedogni5, Gian Vincenzo Zuccotti3. 1. Department of Pediatrics, "V. Buzzi" Children's Hospital, University of Milan, Via Castelvetro 32, 20154 Milan, Italy. Electronic address: Francesca.Penagini@unimi.it. 2. Pediatric Nutrition Unit, "V. Buzzi" Children's Hospital, University of Milan, Via Castelvetro 32, 20154 Milan, Italy. 3. Department of Pediatrics, "V. Buzzi" Children's Hospital, University of Milan, Via Castelvetro 32, 20154 Milan, Italy. 4. Pediatric Orthopedic Unit, "V. Buzzi" Children's Hospital, Via Castelvetro 32, 20154 Milan, Italy. 5. Clinical Epidemiology Unit, Liver Research Center, Building Q, AREA Science Park, Strada Statale 14 km 163.5, 34012, Basovizza, Trieste, Italy.
Abstract
BACKGROUND AND AIMS: Energy requirements are difficult to estimate in children with cerebral palsy (CP). Resting energy expenditure (REE), necessary for personalized nutritional intervention, is most commonly estimated using prediction formulae because the reference method, i.e. indirect calorimetry (IC), is not available in all Nutrition Units. The main aim of the present study was to evaluate the accuracy of the most commonly used REE prediction formulae in children with CP. The secondary aim was to develop a new population-specific formula for the estimation of REE in children with CP. METHODS: REE was measured by IC in 54 children and adolescents with spastic quadriplegic cerebral palsy (SQCP) and estimated from the five most commonly used prediction formulae, i.e. the World Health Organization (WHO), Harris-Benedict, Schofield weight, Schofield weight & height, and Oxford formulae. RESULTS: The mean (standard deviation, SD) difference between the estimated and measured REE was 64 (238) kcal/day for the WHO formula, 79 (226) kcal/day for the Schofield weight formula, 79 (223) kcal/day for the Schofield weight and height formula, 55 (226) kcal/day for the Oxford formula, 37 (224) kcal/day for the Harris-Benedict formula and 0 (213) kcal/day for the purposely developed population-specific formula. Owing to the large SD of the bias, none of these formulae can be reliably applied at the individual level to estimate REE. CONCLUSIONS: The most commonly used REE prediction formulas are inaccurate at both the population and individual level in children with SQCP. A purposely developed population-specific formula, despite being accurate at the population level, does not perform better than the most commonly used REE formulae at the individual level.
BACKGROUND AND AIMS: Energy requirements are difficult to estimate in children with cerebral palsy (CP). Resting energy expenditure (REE), necessary for personalized nutritional intervention, is most commonly estimated using prediction formulae because the reference method, i.e. indirect calorimetry (IC), is not available in all Nutrition Units. The main aim of the present study was to evaluate the accuracy of the most commonly used REE prediction formulae in children with CP. The secondary aim was to develop a new population-specific formula for the estimation of REE in children with CP. METHODS: REE was measured by IC in 54 children and adolescents with spastic quadriplegic cerebral palsy (SQCP) and estimated from the five most commonly used prediction formulae, i.e. the World Health Organization (WHO), Harris-Benedict, Schofield weight, Schofield weight & height, and Oxford formulae. RESULTS: The mean (standard deviation, SD) difference between the estimated and measured REE was 64 (238) kcal/day for the WHO formula, 79 (226) kcal/day for the Schofield weight formula, 79 (223) kcal/day for the Schofield weight and height formula, 55 (226) kcal/day for the Oxford formula, 37 (224) kcal/day for the Harris-Benedict formula and 0 (213) kcal/day for the purposely developed population-specific formula. Owing to the large SD of the bias, none of these formulae can be reliably applied at the individual level to estimate REE. CONCLUSIONS: The most commonly used REE prediction formulas are inaccurate at both the population and individual level in children with SQCP. A purposely developed population-specific formula, despite being accurate at the population level, does not perform better than the most commonly used REE formulae at the individual level.
Authors: Byron Alexander Foster; Jennifer E Lane; Elizabeth Massey; Michelle Noelck; Sarah Green; Jared P Austin Journal: Hosp Pediatr Date: 2020-11-05
Authors: Osman Serhat Tokgoz; Figen Guney; Ahmet Kaya; Ahmet Bugrul; Esra Eruyar; Huseyin Buyukgol; Abdullah Seyithanoglu; Mehmet Sinan Iyisoy Journal: Sisli Etfal Hastan Tip Bul Date: 2021-12-29