先天性心脏病新生儿手术后3个月时的静息能量消耗。
Resting energy expenditure at 3 months of age following neonatal surgery for congenital heart disease.
作者信息
Irving Sharon Y, Medoff-Cooper Barbara, Stouffer Nicole O, Schall Joan I, Ravishankar Chitra, Compher Charlene W, Marino Bradley S, Stallings Virginia A
机构信息
School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA.
出版信息
Congenit Heart Dis. 2013 Jul-Aug;8(4):343-51. doi: 10.1111/chd.12035. Epub 2013 Jan 30.
OBJECTIVE
Infants with Congenital Heart Disease (CHD) often exhibit growth failure. This can affect anthropometric and neurodevelopmental outcomes well into childhood. To determine the resting energy expenditure (REE), body composition, and growth in infants with CHD at 3 months of age, with the secondary aim to identify predictors of REE as compared with healthy infants.
DESIGN AND METHODS
This descriptive study is a subanalysis of a prospective study investigating predictors of growth in postoperative infants with CHD compared with healthy infants. Growth measurements, REE, and body composition were obtained in all infants. Analysis included chi-square for association between categorical variables, t-tests, ANOVA and ANCOVA. Outcome measures included the REE as determined by indirect calorimetry, anthropometric z-scores and body composition at 3 months of age.
SETTING
Participants were recruited from the Cardiac Intensive Care Unit of a large, urban, pediatric cardiac center and pediatric primary care practices.
RESULTS
The analysis included 93 infants, 44 (47%) with CHD. Of the infants with CHD, 39% had single ventricle (SV) physiology. There was no difference in REE related to cardiac physiology between infants with CHD and healthy infants or between infants with SV and biventricular (BV) physiology. Anthropometric z-scores for weight (-1.1 ± 1.1, P < 0.001), length (-0.7 ± 1.1, P < 0.05), and head circumference (-0.6 ± 1.2, P < 0.001) were lower in infants with CHD at 3 months of age. The percentage of body fat (%FAT) in postoperative infants with SV (24% ± 6, P = 0.02) and BV (23% ± 5, P < 0.001) physiology were lower than in healthy infants (27% ± 5), with no difference in REE.
CONCLUSION
At 3 months of age, there was no difference in REE between postsurgical infants with CHD and healthy infants. Infants with CHD had lower growth z-scores and %FAT. These data demonstrate decreased %FAT contributed to growth failure in the infants with CHD.
目的
患有先天性心脏病（CHD）的婴儿常出现生长发育迟缓。这可能会对儿童期的人体测量和神经发育结果产生影响。为了确定3个月大的CHD婴儿的静息能量消耗（REE）、身体成分和生长情况，次要目的是确定与健康婴儿相比REE的预测因素。
设计与方法
这项描述性研究是一项前瞻性研究的子分析，该前瞻性研究调查了与健康婴儿相比，CHD术后婴儿生长的预测因素。对所有婴儿进行了生长测量、REE和身体成分测量。分析包括分类变量之间关联的卡方检验、t检验、方差分析和协方差分析。结果测量包括通过间接量热法测定的REE、3个月大时的人体测量z评分和身体成分。
设置
参与者从一家大型城市儿科心脏中心的心脏重症监护病房和儿科初级保健机构招募。
结果
分析纳入了93名婴儿，其中44名（47%）患有CHD。在患有CHD的婴儿中，39%具有单心室（SV）生理特征。患有CHD的婴儿与健康婴儿之间，或具有SV和双心室（BV）生理特征的婴儿之间，与心脏生理相关的REE没有差异。3个月大的CHD婴儿的体重人体测量z评分（-1.1±1.1，P<0.001）、身长（-0.7±1.1，P<0.05）和头围（-0.6±1.2，P<0.001）较低。具有SV（24%±6，P=0.02）和BV（23%±5，P<0.001）生理特征的术后婴儿的体脂百分比（%FAT）低于健康婴儿（27%±5），REE没有差异。
结论
3个月大时，患有CHD的术后婴儿与健康婴儿的REE没有差异。患有CHD的婴儿生长z评分和%FAT较低。这些数据表明，%FAT降低导致了CHD婴儿的生长发育迟缓。
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