Energy requirements of non-ambulatory, tube-fed adult patients with cerebral palsy and chronic hypothermia

Roland Dickerson, Rex O. Brown, Debra L. Hanna, John E. Williams

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

OBJECTIVES: We investigated the energy requirements of non-ambulatory patients with severe neurodevelopmental disabilities and chronic hypothermia. METHODS: Six adult patients with a permanent ostomy for tube feeding were studied. Otic temperature was taken before the indirect calorimetry measurements. Prescribed tube-feeding intake and nutrient prescription changes were evaluated for 4 y for each patient. Monthly body weights and periodic anthropometric body fat assessments were measured for assessment of the need for weight gain, loss, or maintenance. The prescribed caloric intake was compared with the measured energy expenditure when normothermic, the Harris-Benedict equations, and the Arlington Developmental Center equation for non-ambulatory adult patients with severe neurodevelopmental disabilities (estimated resting energy expenditure [kcal/d] = [22.3 × fat-free mass {kg}] - [9.4 × age {y}] + 557). RESULTS: Mean energy expenditure was 783 ± 81 kcal/d or 29.0 ± 10.9 kcal·kg-1·d-1 when normothermic versus 606 ± 11 kcal/d or 19.5 ± 8.5 kcal·kg-1·d-1 (P < 0.05) when hypothermic (36.9°C ± 0.4 versus 35.5°C ± 0.4; P < 0.02), respectively. Prescribed caloric intakes to achieve weight gain, maintenance and loss were 138 ± 13%, 105 ± 15%, and 74 ± 11% of the measured energy expenditure when normothermic (P < 0.001); 107 ± 19%, 86 ± 18%, and 56 ± 3% of the Harris-Benedict equations (P < 0.02); or 130 ± 23%, 100 ± 19%, and 75 ± 11% of the Arlington Developmental Center equation (P < 0.02). CONCLUSIONS: Measured energy expenditure when the patient is normothermic significantly overestimated actual caloric needs. The energy intake necessary to achieve desired weight changes are restrictive when compared with the basal energy expenditure, Arlington Developmental Center equation, or measured energy expenditure when normothermic.

Original languageEnglish (US)
Pages (from-to)741-746
Number of pages6
JournalNutrition
Volume19
Issue number9
DOIs
StatePublished - Sep 1 2003

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Cerebral Palsy
Hypothermia
Energy Metabolism
Energy Intake
Enteral Nutrition
Weight Gain
Weight Loss
Maintenance
Ostomy
Indirect Calorimetry
Needs Assessment
Prescriptions
Ear
Adipose Tissue
Fats
Body Weight
Weights and Measures
Food
Temperature

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Energy requirements of non-ambulatory, tube-fed adult patients with cerebral palsy and chronic hypothermia. / Dickerson, Roland; Brown, Rex O.; Hanna, Debra L.; Williams, John E.

In: Nutrition, Vol. 19, No. 9, 01.09.2003, p. 741-746.

Research output: Contribution to journalArticle

Dickerson, Roland ; Brown, Rex O. ; Hanna, Debra L. ; Williams, John E. / Energy requirements of non-ambulatory, tube-fed adult patients with cerebral palsy and chronic hypothermia. In: Nutrition. 2003 ; Vol. 19, No. 9. pp. 741-746.
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abstract = "OBJECTIVES: We investigated the energy requirements of non-ambulatory patients with severe neurodevelopmental disabilities and chronic hypothermia. METHODS: Six adult patients with a permanent ostomy for tube feeding were studied. Otic temperature was taken before the indirect calorimetry measurements. Prescribed tube-feeding intake and nutrient prescription changes were evaluated for 4 y for each patient. Monthly body weights and periodic anthropometric body fat assessments were measured for assessment of the need for weight gain, loss, or maintenance. The prescribed caloric intake was compared with the measured energy expenditure when normothermic, the Harris-Benedict equations, and the Arlington Developmental Center equation for non-ambulatory adult patients with severe neurodevelopmental disabilities (estimated resting energy expenditure [kcal/d] = [22.3 × fat-free mass {kg}] - [9.4 × age {y}] + 557). RESULTS: Mean energy expenditure was 783 ± 81 kcal/d or 29.0 ± 10.9 kcal·kg-1·d-1 when normothermic versus 606 ± 11 kcal/d or 19.5 ± 8.5 kcal·kg-1·d-1 (P < 0.05) when hypothermic (36.9°C ± 0.4 versus 35.5°C ± 0.4; P < 0.02), respectively. Prescribed caloric intakes to achieve weight gain, maintenance and loss were 138 ± 13{\%}, 105 ± 15{\%}, and 74 ± 11{\%} of the measured energy expenditure when normothermic (P < 0.001); 107 ± 19{\%}, 86 ± 18{\%}, and 56 ± 3{\%} of the Harris-Benedict equations (P < 0.02); or 130 ± 23{\%}, 100 ± 19{\%}, and 75 ± 11{\%} of the Arlington Developmental Center equation (P < 0.02). CONCLUSIONS: Measured energy expenditure when the patient is normothermic significantly overestimated actual caloric needs. The energy intake necessary to achieve desired weight changes are restrictive when compared with the basal energy expenditure, Arlington Developmental Center equation, or measured energy expenditure when normothermic.",
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AU - Dickerson, Roland

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AU - Hanna, Debra L.

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N2 - OBJECTIVES: We investigated the energy requirements of non-ambulatory patients with severe neurodevelopmental disabilities and chronic hypothermia. METHODS: Six adult patients with a permanent ostomy for tube feeding were studied. Otic temperature was taken before the indirect calorimetry measurements. Prescribed tube-feeding intake and nutrient prescription changes were evaluated for 4 y for each patient. Monthly body weights and periodic anthropometric body fat assessments were measured for assessment of the need for weight gain, loss, or maintenance. The prescribed caloric intake was compared with the measured energy expenditure when normothermic, the Harris-Benedict equations, and the Arlington Developmental Center equation for non-ambulatory adult patients with severe neurodevelopmental disabilities (estimated resting energy expenditure [kcal/d] = [22.3 × fat-free mass {kg}] - [9.4 × age {y}] + 557). RESULTS: Mean energy expenditure was 783 ± 81 kcal/d or 29.0 ± 10.9 kcal·kg-1·d-1 when normothermic versus 606 ± 11 kcal/d or 19.5 ± 8.5 kcal·kg-1·d-1 (P < 0.05) when hypothermic (36.9°C ± 0.4 versus 35.5°C ± 0.4; P < 0.02), respectively. Prescribed caloric intakes to achieve weight gain, maintenance and loss were 138 ± 13%, 105 ± 15%, and 74 ± 11% of the measured energy expenditure when normothermic (P < 0.001); 107 ± 19%, 86 ± 18%, and 56 ± 3% of the Harris-Benedict equations (P < 0.02); or 130 ± 23%, 100 ± 19%, and 75 ± 11% of the Arlington Developmental Center equation (P < 0.02). CONCLUSIONS: Measured energy expenditure when the patient is normothermic significantly overestimated actual caloric needs. The energy intake necessary to achieve desired weight changes are restrictive when compared with the basal energy expenditure, Arlington Developmental Center equation, or measured energy expenditure when normothermic.

AB - OBJECTIVES: We investigated the energy requirements of non-ambulatory patients with severe neurodevelopmental disabilities and chronic hypothermia. METHODS: Six adult patients with a permanent ostomy for tube feeding were studied. Otic temperature was taken before the indirect calorimetry measurements. Prescribed tube-feeding intake and nutrient prescription changes were evaluated for 4 y for each patient. Monthly body weights and periodic anthropometric body fat assessments were measured for assessment of the need for weight gain, loss, or maintenance. The prescribed caloric intake was compared with the measured energy expenditure when normothermic, the Harris-Benedict equations, and the Arlington Developmental Center equation for non-ambulatory adult patients with severe neurodevelopmental disabilities (estimated resting energy expenditure [kcal/d] = [22.3 × fat-free mass {kg}] - [9.4 × age {y}] + 557). RESULTS: Mean energy expenditure was 783 ± 81 kcal/d or 29.0 ± 10.9 kcal·kg-1·d-1 when normothermic versus 606 ± 11 kcal/d or 19.5 ± 8.5 kcal·kg-1·d-1 (P < 0.05) when hypothermic (36.9°C ± 0.4 versus 35.5°C ± 0.4; P < 0.02), respectively. Prescribed caloric intakes to achieve weight gain, maintenance and loss were 138 ± 13%, 105 ± 15%, and 74 ± 11% of the measured energy expenditure when normothermic (P < 0.001); 107 ± 19%, 86 ± 18%, and 56 ± 3% of the Harris-Benedict equations (P < 0.02); or 130 ± 23%, 100 ± 19%, and 75 ± 11% of the Arlington Developmental Center equation (P < 0.02). CONCLUSIONS: Measured energy expenditure when the patient is normothermic significantly overestimated actual caloric needs. The energy intake necessary to achieve desired weight changes are restrictive when compared with the basal energy expenditure, Arlington Developmental Center equation, or measured energy expenditure when normothermic.

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