The effect on energy metabolism and fuel utilization of increasing energy intake by adding intravenous lipid to a glucose and amino acid regimen was examined. Twenty fullterm, appropriate-for-gestational-age, intravenously fed neonates were entered into one of two groups: total energy intake was 261 kJ.kg-1 x d-1 (62 kcal.kg-1 x d-1) in group 1 and 355 kJ.kg-1 x d-1 (85 kcal.kg-1 x d-1) in group 2. Both groups received 2.8 g protein.kg-1 x d-1 and 14 g glucose.kg-1 x d-1. Group 2 received an additional 2 g lipid.kg-1 x d-1. Metabolic rate, respiratory gas exchange, and nonprotein substrate oxidation were similar in both groups. The addition of energy as lipid enhanced nitrogen retention (230 vs 306 mg.kg-1 x d-1; P < 0.02) and utilization (52.8% vs 66.5%; P < 0.03). Our data suggest that nitrogen utilization is improved in parenterally fed neonates by adding fat and increasing energy intake without change in metabolic rate, carbon dioxide production, oxygen consumption, and nonprotein substrate utilization. Energy expenditure does not necessarily increase with increasing energy intake independently of diet composition.

Change in abundance of 2H and 18O in dietary water during a doubly labeled water energy period may introduce error into the calculated carbon dioxide production rate (RCO2). To examine the accuracy of 2H2(18)O during changing nutritional regimens, we compared 2H2(18)O and periodic open-circuit respiratory gas exchange (RGE) in postsurgical infants who were changing from parenteral to alternative parenteral and/or oral nutrition. The two methods were compared before and after correction for shifts in isotopic abundance of the infant water pools during the energy-expenditure period. Baseline corrections were predicted using the difference between abundances of the initial body water and final nutrient solutions. Before isotopic correction, 2H2(18)O underestimated RCO2 in eight subjects by 11.8 +/- 20.1% (mean +/- SD). After correction, agreement between the two methods improved; the underestimate was then -8.7 +/- 12.9%. To obtain maximum precision of 2H2(18)O, subjects should be maintained on the same nutritional regimen before and during the study unless valid correction formulae are used.

ABSTRACT: Previous studies show that the doubly labeled water method is accurate for measuring energy expenditure in the adult human. To validate this method in infants, carbon dioxide production rate and energy expenditure were measured for 5 to 6 days by doubly labeled water (DLW) and periodic open circuit respiratory gas exchange (RGE) in 10 blinded studies in nine infants following abdominal surgery. Infants were maintained on consistant oral or parenteral nutrition prior to and during study. This avoided diet-related changes in baseline isotopic enrichment of body water which could theoretically contribute to significant errors in calculation of carbon dioxide production rate. For DLW, insensible water loss was assumed to be proportional to respiratory volume and body surface area, where the former was predicted from carbon dioxide production rate. Insensible water loss thus calculated averaged 18% of water turnover. Rates of carbon dioxide production measured by DLW were not significantly different from that of RGE (10.4 ± 1.1 and 10.5 ± 0.9 1/kg/day, mean ± SD, respectively). Energy expenditure was calculated using respiratory quotients from dietary intake (DLW:DIET) and RGE (DLW:RGE) data. There was no significant difference between energy expenditure determined by DLW (DLW:DIET and DLW:RGE) and that measured by RGE (58.5 ± 6.1, 56.8 ± 6.1, and 57.3 ± 5.1 kcal/kg/day, mean ± SD, respectively). Rate of carbon dioxide production, DLW:diet, and DLW:RGE calculated by DLW differed from corresponding RGE values by - 0.9 ± 6.2, -1.1 ± 6.1, and 1.6 ± 6.2%, mean ± SD, respectively. These findings demonstrate the validity of the doubly labeled water method for determining energy expenditure in infants without concurrent water balance studies.

In order ro determine the effect of MCT diet on “quality growth” (i.e. protein vs. fat deposition) we investigated the effect of feeding an MCT-enriched formula (Group I; n=8) vs. OMM (Group II; n=9) on oxidation (oxid.) and accretion (accr.) of energy, macronutrients and growth in 17 healthy VLBW infants combining macronutrient balance, indirect calorimetry and anthropometry. 14 studies were performed in Group I and 13 in Croup II. Clinical parameters and energy intake were comparable in both groups. Results are demonstrated in the table (*p<0.01; *p≤0.05) Oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory quotient (RQ) and weight gain did not differ in the two groups. The composition of weight gain indicated a higher percent of fat per gram weight gain in Group I (25.5%) than in Grp.II (14.7%). Protein accretion was similar. Conclusions: 1) Although weight gain was similar in the infants fed either OMM or MCT formula, the composition of weight gain in the MCT group favoured more fat, presumably due to the higher fat intake and lower losses. 2) Similar VO2, VCO2 and RQ indicate a similar proportion of carbohydrate and fat oxidation. 3) Since MCT diet did not promote fat oxidation, we assume that part of MCT is diverted into the chain elongation pathway in the liver of the preterm infant.

An analysis of personnel and facilities used for transfer of sick newborn infants to the Neonatal Intensive Care Unit of The Hospital for Sick Children, Toronto during the months November 1971 and February to April 1972 showed many deficiencies. In many instances severely ill patients were accompanied by inadequately trained staff, transport incubators were either inadequate to maintain the babies' temperatures or were used inappropriately, resuscitation facilities were not available and oxygen concentrations could neither be measured nor varied as desired.Infants who weighed less than 1500 g. at birth and who died following transfer had significantly lower mean body temperatures on arrival at the referral hospital than those who survived. Mean transport incubator temperatures were too low in all groups of infants but were lower in those who died, although the difference was not statistically significant.

Summary Fifty‐two infants with hypoglycaemia were seen over a 12 month period. Six of these infants had cardiac enlargement with signs of failure and pulmonary oedema in association with isolated hypoglycaemia. Signs and symptoms suggestive of cardiac failure corresponded to the period of hypoglycaemia and disappeared when blood sugar levels were raised by appropriate treatment.

Research Articles| September 15 2009 Intrapulmonary Venous Admixture in the Respiratory Distress Syndrome Subject Area: Women's and Children's Health A.I. Murdock; A.I. Murdock Research Institute of The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto Search for other works by this author on: This Site PubMed Google Scholar B.S.L. Kidd; B.S.L. Kidd Research Institute of The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto Search for other works by this author on: This Site PubMed Google Scholar M.A. Llewellyn; M.A. Llewellyn Research Institute of The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto Search for other works by this author on: This Site PubMed Google Scholar M.McC. Reid; M.McC. Reid Research Institute of The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto Search for other works by this author on: This Site PubMed Google Scholar P.R. Swyer P.R. Swyer Research Institute of The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto Search for other works by this author on: This Site PubMed Google Scholar Biologia Neonatorum (1970) 15 (1-2): 1–7. https://doi.org/10.1159/000240204 Article history Published Online: September 15 2009 Content Tools Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation A.I. Murdock, B.S.L. Kidd, M.A. Llewellyn, M.McC. Reid, P.R. Swyer; Intrapulmonary Venous Admixture in the Respiratory Distress Syndrome. Biologia Neonatorum 31 December 1970; 15 (1-2): 1–7. https://doi.org/10.1159/000240204 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsNeonatology Search Advanced Search Article PDF first page preview Close Modal This content is only available via PDF. 1970Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. You do not currently have access to this content.