Gastrointestinal absorption and protein energy metabolism in infants with chronic lung disease

Undernutrition and growth failure in infants with chronic lung disease(CLD)remains one of the major clinical problems for pediatricians，but the cause is unknown。Recent reports showed that undernutrition is a major contributing factor in the pathogenesis of CLD.We measured the energy metabolism and the activities of lipase and trypsin in aspirated duodenal juice of very low birth weight infants(VLBWI)with and without CLD.To examine the difference in energy metabolism of 13VLBWI(6cases with CLD，7cases without CLD)，a metabolic gas monitor(MGM/jr.)Was used to obtain oxygen consumption and carbon dioxide production.Oxygen consumption(9.9±1.3 versus 8.5±1.1 ml/kg/min：p&lt；0.05)，and energy expenditure(71.6±10.3 versus 61.1±7.9kcal/kg/day：p&lt；0.05)were higher in infants with CLD.Total energy intake(80.2±11.9 versus 98.2±7.9kcal/kg/day：p&lt；0.01)was lower in infants with CLD.The activities of lipase and trypsin were measured in preprandially aspirated duodenal juice of 20VLBWI during8weeks of postnatal period.The activities of both enzymes significantly increased with postnatal age.These 20 infants were allocated into two groups according to oxygen supplemented period and ventilatory supported period.The pancreatic enzyme activity of the infants who needed longer O I D22 II D2 supplementation and ventilatory support were lower than the others。From these results，we concluded that careful and individual nutritional management was needed in the VLBW infants with CLD who require long term ventilatory supports.

Undernutrition and growth failure in infants with chronic lung disease (CLD) remains one of the major clinical problems for pediatricians, but the cause is unknown. Recent reports showed that undernutrition is a major contributing factor in the pathogenesis of CLD. We measured the energy metabolism and the activities of lipase and trypsin in aspirated duodenal juice of very low birth weight infants (VLBWI) with and without CLD. To examine the difference in energy metabolism of 13 VLBWI (6 cases with CLD, 7cases without CLD), a metabolic gas monitor (MGM/jr.) was used to obtain oxygen consumption and carbon dioxide production. Oxygen consumption (9.9±1.3 versus 8.5±1.1 ml/kg/min : p<0.05), and energy expenditure (71.6±10.3 versus 61.1±7.9 kcal/kg/day : p<0.05) were higher in infants with CLD. Total energy intake ( 80.2±11.9 versus 98.2±7.9 kcal/kg/day : p<0.01) was lower in infants with CLD. The activities of lipase and trypsin were measured in preprandially aspirated duodenal juice of 20 VLBWI during 8 weeks of postnatal period. The activities of both enzymes significantly increased with postnatal age. These 20 infants were allocated into two groups according to oxygen supplemented period and ventilatory supported period. The pancreatic enzyme activity of the infants who needed longer OィイD22ィエD2 supplementation and ventilatory support were lower than the others. From these results, we concluded that careful and individual nutritional management was needed in the VLBW infants with CLD who require long term ventilatory supports.