Energy expenditure in children with cerebral palsy and moderate / severe malnutrition during nutritional recovery

Nutr Hosp. 2015 May 1;31(5):2062-9. doi: 10.3305/nh.2015.31.5.8588.

Abstract

Objective: To analyze the total energy expenditure (TEE) and resting energy expenditure (REE) in children with cerebral palsy (CP) and moderate or severe malnutrition during nutritional recovery.

Methods: In an intervention study, thirteen subjects with CP (10 females and 3 males with a mean age of 9y11m ± 2y3m), level V of the Gross Motor Function Classification System and moderate or severe malnutrition were included. Eight were fed by nasogastric tube and five by gastrostomy. They were compared with 57 healthy participants (31 females and 26 males with mean age of 8y7m ± 10m). Anthropometric measurements, body composition and energy expenditure by bioelectrical impedance analysis (BIA) and indirect calorimetry (IC) were performed in both groups.

Results: TEE and REE were higher in healthy children than in children with CP in kcal/d and kcal/cm/d but were lower in kcal/kg/d (p <0.001). Intensive nutritional support for four weeks in children with CP produced a significant increase in energy expenditure.

Conclusion: TEE and REE, in children with CP, are lower than in healthy children. Estimating the REE in children with CP and malnutrition is better performed in kcal/kg/d than in kcal/cm/d. Fat-free mass (FFM) is a good predictor of the REE in healthy children and children with CP.

Objetivo: Analizar el gasto energético total (GET) y gasto energético basal (GEB) en niños con parálisis cerebral infantil (PCI) y desnutrición moderada o grave durante la recuperación nutricia. Métodos: En un estudio de intervención, se incluyeron trece sujetos con PCI (10 mujeres y 3 hombres, con una edad promedio de 9a11m±2a3m), pertenecían al nivel V del Sistema de Clasificación de la Función Motora Gruesa y desnutrición moderada o grave. Ocho fueron alimentados por sonda nasogástrica y cinco por gastrostomía. Se compararon con 57 participantes sanos (31 mujeres y 26 varones con una edad promedio de 8a7m±10m). Se realizaron mediciones antropométricas, de composición corporal y de gasto energético mediante el análisis de impedancia bio-eléctrica (IBE) y calorimetría indirecta (CI) en ambos grupos. Resultados: El GET y GEB fueron mayores en los niños sanos que en los niños con parálisis cerebral en kcal/d y kcal/cm/d, pero fueron menores en kcal/kg/día (p.

MeSH terms

  • Anthropometry
  • Body Composition
  • Cerebral Palsy / complications
  • Cerebral Palsy / physiopathology*
  • Cerebral Palsy / therapy*
  • Child
  • Energy Metabolism*
  • Enteral Nutrition
  • Female
  • Humans
  • Male
  • Malnutrition / complications
  • Malnutrition / physiopathology*
  • Malnutrition / therapy*
  • Nutritional Support / methods*