Abstract
Effect of calorie intake on the utilization of carbohydrate(C) protein(P) and fat(F) as energy substrate in the ill newborn infant on total parenteral nutrition(TPN). Energy (Kcal)input for infants may need to be restricted due to glucose(GL) or Intralipid(IL)intolerance caused by a variety of diseases. Using indirect calorimetry(IC) and urinary nitrogen output (UN) at thermoneutrality,energy needs from endogenous and exogenous sources were determined by studying 34 infants at TPN intakes(INT.) from 20-110 Kcal/Kg/day by GL alone,by GL plus amino acid(AA) or GL+AA+IL infusions. Resting metabolic rate(RMR)correlated positively with Kcal INT.(r=0.58 p<0.001).With GL+AA infusion the contribution of endogenous F to energy metabolism was inversely proportional to Kcal INT.(r=0.91 p<0.001)until an INT.of 70 Kcal/Kg/d.was provided from exogenous sources.Over an INT.of 70 Kcal/Kg/d, a large proportion of infused IL was oxidised(OXID.:60-70%)and the balance deposited.
Thus(a)neonates show metabolic flexibility to diverse substrates(b) the proportion of protein OXID.is independent of calorie INT. (c) fat emulsion is used preferentially as an energy substrate with less than 30-40% assimilation.(data are expressed as M±SD).
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Putet, G., Verellen, G., Heim, T. et al. Abstracts, Annual Meeting, The European Society for Paediatric Research and The Working Group on Mineral Metabolism. Pediatr Res 13, 72 (1979). https://doi.org/10.1203/00006450-197901000-00015
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DOI: https://doi.org/10.1203/00006450-197901000-00015