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2019

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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REST ENERGY EXPENDITURE, RESPIRATORY QUOTIENT AND THE BODY COMPOSITION IN THE CONVALESCENCE AFTER MAJOR SURGERY OF INFANTS BORN AT TERM: AN EXPLORATORY ANALYSIS

Luis Pereira-da-Silva1-3, Luísa Rodrigues2, Ana Catarina Moreira3, Daniel Virella4, Marta Alves4, Miguel Correia2, Gonçalo Cordeiro-Ferreira2

1 - Neonatal Intensive Care Unit, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon
2 - Nutrition Lab, Department of Pediatrics, Hospital, Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon
3 - Dietetics and Nutrition, Lisbon School of Health Technology, Lisbon
4 - Research Unit, Centro Hospitalar de Lisboa Central, Lisbon

- Comunicação livre - XLIII Jornadas Nacionais de Neonatologia, Régua, 15/11/2014
- Prémio de melhor comunicação livre das Jornadas

Introduction
Knowledge on the metabolic changes and nutritional needs during the postsurgical anabolic phase in infants is scarce. This case-study explores the associations of resting energy expenditure (REE) and macronutrient utilization with body composition of full-term infants during the anabolic phase after corrective surgery of major congenital anomalies.

Methods
Full-term appropriate for-gestational-age neonates subjected to corrective surgery of major congenital anomalies were recruited after gaining weight for at least one week for this prospective observational study. REE and macronutrient utilization, measured by respiratory quotient (RQ), were assessed by indirect calorimetry using the Deltatrac II Metabolic MonitorÒ. Body composition, expressed as fat-free mass (FFM), fat mass (FM) and adiposity defined as percentage of FM (%FM), was measured by air displacement plethysmography using the Pea PodÒ.

Results
Four patients were included at 3 to 5 postnatal weeks. Recommended energy and macronutrient intakes for healthy term infants were provided. Through the study, the median (min-max) REE (Kcal/Kg FFM/d) was 70.8 (60.6-96.1) and RQ was 0.99 (0.72-1.20). Steady increases in both body weight and FFM were associated with initial decrease in FM and adiposity followed by their increase. Low RQ preceded decrease in adiposity.

Conclusion
The novel finding of marked adiposity depletion, not expected while on steady weight gain in the postsurgical anabolic phase, prompts us to report this finding. The subsequent adiposity catch-up was associated with relatively high REE and RQ, suggesting preferential oxidation of carbohydrates and preservation of lipids for fat storage.

Key-words: adiposity; air displacement plethysmography; body composition; maternal LCPUFA intake; newborn