Abstract
Growth failure was studied in infants with BPD by relating their nutritional balance and growth to past and current clinical status. Total daily energy expenditure (TEE) was measured with doubly labeled water in 9 preterm infants with BPD receiving supplemental oxygen (all male, age 61±13 days) and 9 matched controls (5 male, age 36 ±21 days) during a 6 day period. Energy and protein balance, and growth were assessed as well. TEE was higher in the BPD infants compared to controls (73 ±9 vs. 63 ±8 kcal/kg/day, P < 0.05), but faecal energy loss in BPD infants was lower (P < 0.01). Weight gain, energy intake, energy cost of growth, protein retention, and physical activity were not different. The respiratory frequency (RR) in the BPD infants was elevated in comparison with controls (P< 0.01); within the BPD group RR was significantly associated with energy expenditure (r2 = 0.82, P < 0.001). The fitted equation was TEE[kcal/kg/day] = 26.3 + 0.71*RR [min-1]. We conclude that total energy expenditure in BPD infants is elevated, and is strongly associated with their respiratory status. These findings support the use of high-energy feeding for the nutritional management in infants with severe BPD.
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