Weekly Measurements Accurately Represent Trends in Resting Energy Expenditure in Children Undergoing Hematopoietic Stem Cell Transplantation

Abstract

Background: Resting energy expenditure (REE) measurements are optimal for accurate assessment of energy requirements and precise provision of parenteral nutrients. We previously observed significant reduction in REE during a 4-week period in children undergoing hematopoietic stem cell transplantation (HSCT). The goal of this study was to determine if weekly REE measurements could accurately represent changes in REE in the peritransplant period compared with a more frequent standard of daily measurements. Methods: Data are presented from a previously described cohort of 37 children undergoing HSCT. We performed weekly indirect calorimetry on 25 patients; of those 25, we performed daily measurements on a convenience sample of 5 children. The time course of REE was analyzed in each sample by repeated measures regression. Results: The REE trend of the 20 weekly participants was similar to that of the 5 daily participants, reaching about 80% of predicted REE at 4 weeks posttransplant, with an average decline of 3.4% per week during 4 weeks. Conclusion: The results suggest that weekly REE measurements accurately characterize REE changes 4 weeks after HSCT compared with daily measurements. Characterization of these trends using weekly measurements may help guide clinical and nutrition care of these patients.

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References

Duggan C, Bechard L, Donovan K, et al. Changes in resting energy expenditure among children undergoing allogeneic stem cell transplantation. Am J Clin Nutr. 2003 ;78:104 -109.

Muscaritoli M, Grieco G, Capria S, Iori AP, Fanelli FR. Nutrition and metabolic support in patients undergoing bone marrow transplantation. Am J Clin Nutr. 2002 ;75:183 -190.

Didi M, Didcock E, Davies HA, Ogilvy-Stuart AL, Wales JK, Shalet SM. High incidence of obesity in young adults after treatment of acute lymphoblastic leukemia in childhood. J Pediatr. 1995 ;127:63 -67.

Birkebaek NH, Clausen N. Height and weight pattern up to 20 years after treatment for acute lymphoblastic leukemia. Arch Dis Child. 1998;79:161 -164.

Taskinen M, Saarinen-Pihkala UM, Hovi L, Lipsanen-Nyman M. Impaired glucose tolerance and dyslipidemia as late effects after bone-marrow transplantation in childhood. Lancet. 2000 ;356:993 -997.

Framson CM, LeLeiko NS, Dallal GE, Roubenoff R, Snelling LK, Dwyer JT. Energy expenditure in critically ill children. Pediatr Crit Care Med. 2007;8:264 -267.

Ringwald-Smith KA, Heslop HE, Krance RA, et al. Energy expenditure in children undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant. 2002 ;30:125 -130.

FAO/WHO. Energy and protein requirements. Report of a joint FAO/WHO ad hoc expert committee. Rome, March 22-April 2 1971. FAO Nutr Meet Rep Ser. 1973;(52):1 -118.

Schofield WN. Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr. 1985 ;39(Suppl 1):5 -41.

10.

Frisancho A. New norms of upper limb fat and muscle areas for assessment of nutrition status. Am J Clin Nutr. 1981 ;34:2540 -2545.

11.

Smyrnios NA, Curley FJ, Shaker KG. Accuracy of 30-minute indirect calorimetry studies in predicting 24-hour energy expenditure in mechanically ventilated, critically ill patients. JPEN J Parenter Enteral Nutr. 1997;21:168 -174.

12.

Rising R, Duro D, Cedillo M, Valois S, Lifshitz F. Daily metabolic rate in healthy infants. J Pediatr. 2003 ;143:180 -185.