Resting Energy Expenditure Measured by Indirect
Calorimetry in Infants and Young Children with
Chronic Lung Disease
Watsamon Jantarabenjakul MD*, Sompol Sanguanrungsirikul MD**,
Suchada Sritippayawan MD***, Orapa Suteerojntrakool MD*, Sirinuch Chomtho MD, PhD***
Affiliation :
* Department of Pediatrics, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
** Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
*** Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective : To determine resting energy expenditure (REE) by indirect calorimetry and to compare measured resting energy
expenditure (mREE) by indirect calorimetry with prediction equations (pREE).
Material and Method: Infants and young children with chronic lung diseases from King Chulalongkorn Memorial Hospital
were enrolled and assessed for nutritional status and severity of chronic lung diseases. For mREE, indirect calorimetry
was performed by custom-made airtight canopy with O2 and CO2 sensors, with the patients were in a resting state.
Prediction equations were Food and Agriculture/World Health Organization/United Nations University (FAO/WHO/UNU),
Schofield-Weight, Schofield-Weight/Height, Harris Benedict, and Harris Benedict-Infant equations. Agreement between
mREE and pREE was assessed by Bland-Altman method.
Results : Eighteen patients (median age 6 months, range 1 to 26 months) were recruited. Sixteen children had weight
for age Z-score below -2 SD. Median weight for age Z-score, length for age Z-score and weight for length Z-score were
-3.0, -3.1, and -1.9, respectively. Median mREE was 53.8 kcal/kg/day (interquartile range 47.5 to 72.6 kcal/kg/day). The
Schofield-Weight/Height equation showed the lowest mean of difference at 0.94 kcal/kg/day with 95% confidence interval
for the bias -44.4 to 46.3 kcal/kg/day.
Conclusion : To ensure optimal nutritional support, REE should be measured by indirect calorimetry in pediatric patients
with chronic lung diseases. Based on our finding, the Schofield-Weight/Height equation was the most accurate equation for
predicting REE in this group of patients.
Keywords : Resting energy expenditure, Indirect calorimetry, Chronic lung disease, Prediction equations
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