Abstract
Premature neonates are in an energy deficient state due to (1) oxygen desaturation and hypoxia events, (2) painful and stressful stimuli, (3) illness, and (4) neurodevelopmental energy requirements. Failure to correct energy deficiency in premature infants may lead to adverse effects such as neurodevelopmental delay and negative long-term metabolic and cardiovascular outcomes. The effects of energy dysregulation and the challenges that clinicians in the Neonatal Intensive Care Unit (NICU) face in meeting the premature infant’s metabolic demands are discussed. Specifically, the focus is on the effects of pain and stress on energy homeostasis. Energy deficiency is a complex problem and requires a multi-faceted solution to promote optimum development of premature infants.
Highlights
Premature infants face numerous challenges during their stay in the neonatal intensive care unit (NICU). Do they face the challenge of being underdeveloped compared to term infants, they are at risk to a variety of illnesses, as well as undernutrition and growth failure [1,2], These factors lead to a state of energy deficiency and catabolism, with potential long-term effects such as impaired neuronal development [3,4] and metabolic diseases [5,6]
The premature condition in the context of routine clinical procedures, energy metabolism and prospective long-term outcomes of energy deficit are of interest
We explored theby effects of tissue damaging procedureslipids (TDPs) increase in adenosine triphosphate (ATP) performed degradation in response painful procedures may be or duevenous to energy expended
Summary
Premature infants (less than 37 weeks gestational age) face numerous challenges during their stay in the neonatal intensive care unit (NICU) Do they face the challenge of being underdeveloped compared to term infants, they are at risk to a variety of illnesses, as well as undernutrition and growth failure [1,2], These factors lead to a state of energy deficiency and catabolism, with potential long-term effects such as impaired neuronal development [3,4] and metabolic diseases [5,6]. Ill neonates and premature infants in particular, undergo multiple (from 4 to 16) tissue damaging procedures (TDPs) for clinical care or diagnostic purposes [7,8,9]. The objective of this narrative review is to summarize the complexity of the metabolic demands of the premature neonate, as well as the potential consequences of not meeting these demands, leading to energy deficit
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