The Research Of Energy Expenditure Of Neonatal Pneumonia

Background:Neonatal pneumonia is a common and frequently encountered disease in the neonatal period.At present,there are few reports about the energy expenditure of neonatal pneumonia in China and abroad.The difference in energy consumption of pneumonia between healthy neonates and neonates with pneumonia,premature infants and full term infants,light and severe neonatal pneumonia is still blank.Neonatal pneumonia has high catabolism and energy consumption.It causes the newborns to lose weight and affects their growth and development.Providing reasonable energy support timely is good for children’s recovery and healthy growth[1].So the research of energy expenditure of neonatal pneumonia has important theoretical and clinical value.Compared with the full term infants,premature infants are born with low nutritional and energy reserves and their nutritional intake is poor.The prevalence rate of pneumonia in premature infants is high and the disease recovery is slow.Its malnutrition and disease state can affect future growth and development[2]and even lead to cardiopulmonary dysfunction and delayed development of the nervous system in the future.It is of great significance to study the energy metabolism of premature pneumonia,so as to help early clinical intervention of energy needs of premature infants and give them reasonable nutrition support.Severe pneumonia has higher catabolism and energy consumption.It causes the body weight to drop obviously and malnutrition,which affects recover of the illness.Neonatal light pneumonia has less effect on neonatal growth than severe pneumonia.Therefore,it is very important to study the energy consumption of neonates with light and severe pneumonia,so as to help them to give reasonable energy support at the early clinical stage and promote their recovery.We measured the 24-hour energy expenditure of healthy newborns and newborns with pneumonia on the first day of admission respectively.We compared the difference of energy consumption between healthy neonates and neonates with pneumonia.We analyzed the factors that may be associated with high energy metabolism of neonatal pneumonia and the influence of related factors on energy consumption of neonatal pneumonia.Then we compared the 24-hour energy consumption difference of healthy premature infants and full term infants,pneumonia premature infants and full term infants,healthy premature infants and pneumonia premature infants,healthy full term infants and pneumonia full term infants and light and severe neonatal pneumonia respectively.The purpose of our research was to explore the difference of energy consumption between healthy neonates and neonates with pneumonia and related factors of energy expenditure.Further to explore the differences of energy expenditure of healthy newborns and neonatal pneumonia in different gestational age(preterm infants and full term infants).Further to explore the differences of energy expenditure of neonatal pneumonia in different degrees of illness(light and severe).Providing theoretical basis for the reasonable nutritional support and diagnosis of neonatal pneumonia.Objective:The aim of this research was to study the difference of energy consumption between healthy neonates and neonates with pneumonia.To study the influencing factors of energy consumption in healthy newborns and neonates with pneumonia and analyze the influence of related factors on energy consumption of neonatal pneumonia.Further to explore the differences of energy expenditure of healthy newborns and neonatal pneumonia in different gestational age(preterm infants and full term infants).To explore the differences of energy expenditure of neonatal pneumonia in different degrees of illness(light and severe).Providing theoretical basis for the reasonable nutritional support and diagnosis of neonatal pneumonia.Methods:We selected neonatal pneumonia in Children Hospital of Medical College of Zhejiang University for observer group and selected healthy newborns in Women’s Hospital School Of Medicine Zhejiang University for control group between June 2013 and June 2018.We established a database according to the inclusion and exclusion criteria.After obtaining informed consent,the newborn general situation questionnaire(table 1)and the maternal situation questionnaire during pregnancy and delivery(table 2)will be completed by the mother.Then measuring energy expenditure by using combined heart rate acceleration sensor Actiheart(Cajmntech company in the United States).After eliminating the lost data because of discharging from hospital or the falling of the instruments during test,we finally got 106-samples.According to the gestational age,there were 63 samples of full term infants and 43 samples of premature infants with pneumonia.According to the different degrees of illness,there were 81 light samples and 25 severe samples with pneumonia.The control group had 182 samples of healthy newboms,including 101 samples of full term infants and 81 samples of premature infants.Advanced Energy Expenditure mode was employed to measure energy expenditure for 24 hours.The data we collected contained energy expenditure indicators Physical Activity Energy Expentiture(PAEE)and Total Energy Expenditure(TEE).After examining table 1 and table 2,the unified number shall be conducted.The data of table 1 and table 2 and the corresponding data of PATT,TEE,gender,gestational age,the measured weight and height,breathing rate,heart rate,fever,cough,asthma,blood WBC,CRP,antibiotics,light and severe disease on the first day of admission,days of wet sound disappeared in the lung and hospitalization days merge into the Excel table.The database is established.The exported data were statistically analyzed by SPSS22.0.Results:1.The difference of energy consumption between healthy neonates and neonates with pneumonia(1)The PAEE value of neonates with pneumonia(363.31±121.02)kj/kg/d was significantly higher than healthy neonates(82.02±73.00)kj/kg/d,and the TEE value of neonates with pneumonia(1192.70±180.98)kj/kg/d was significantly higher than healthy neonates(574.70±268.50)kj/kg/d,and the difference was statistically significant.2.Factors that may be associated with high energy metabolism of neonatal pneumonia(1)Gestational age was<0.05 compared with the PAEE and TEE of healthy newborns,and there was a statistical difference.(2)The four factors of fever,breathing rate,heart rate and light and severe disease were all<0.05 compared with the PAEE and TEE of neonatal pneumonia,and there was a statistical difference.And the breathing rate and heart rate was all<0.05 compared with severity of disease,and there was a statistical difference.3.Differences of energy expenditure of healthy newborns and neonatal pneumonia in different gestational age(preterm infants and full term infants)(1)The PAEE value of healthy premature infants(123.31±75.24)kj/kg/d wassignificantly higher than the healthy full term infants(48.91±51.26)kj/kg/d,but the TEE value of healthy premature infants(373.80±168.99)kj/kg/d was lower than the healthy full term infants(735.81±220.76)kj/kg/d,and the difference was statistically significant.(2)The PAEE value of pneumonia premature infants(367.53±99.53)kj/kg/d was significantly higher than the healthy premature infants(123.3 1±75.24)kj/kg/d,and the TEE value of pneumonia premature infants(1157.81±129.31)kj/kg/d was significantly higher than the healthy premature infants(373.80±168.99)kj/kg/d,and the difference was statistically significant.(3)The PAEE value of pneumonia full term infants(354.44± 134.19)kj/kg/d was significantly higher than the healthy full term infants(48.91±51.26)kj/kg/d,and the TEE value of pneumonia full term infants(1216.51±206.70)kj/kg/d was significantly higher than the healthy full term infants(735.81±220.76)kj/kg/d,and the difference was statistically significant.(4)The PAEE and TEE values of pneumonia premature infants compared with pneumonia full term infants have no significant difference.4.Differences of energy expenditure of neonatal pneumonia in different degrees of illness(light and severe)(1)The PAEE value of light neonatal pneumonia(335.35±111.31)kj/kg/d was lower than severe neonatal pneumonia(438.84±119.23)kj/kg/d,and the TEE value of light neonatal pneumonia(1151.91 ± 163.50)kj/kg/d was lower than severe neonatal pneumonia(1324.84±174.33)kj/kg/d,and the difference was statistically significant.Conclusion:1.The PAEE and TEE values of neonates with pneumonia were higher than those of healthy neonates.2.The influence factor of PAEE and TEE values of healthy newborn could be gestational age.3.The influence factors of PAEE and TEE values of neonatal pneumonia were x fever,breathing rate,heart rate and light and severe disease.Further more,there was correlation between severity of disease with breathing rate,heart rate.When the disease of neonatal pneumonia was heavier,the breathing rate and heart rate was faster,the corresponding PAEE and TEE value was also higher.4.Within a certrain gestational age range,the PAEE value of healthy premature infants was higher than the healthy full term infants,but the TEE value of healthy premature infants was lower than the healthy full term infants.Within a certain gestational age range,the PAEE and TEE values of pneumonia premature infants were higher than those of healthy premature infants.Within a certain gestational age range,the PAEE and TEE values of pneumonia full term infants were higher than those of healthy full term infants.In the same gestational age,the neonatal energy consumption of pneumonia was greater than that of healthy newborns within a certain gestational age range.The PAEE and TEE values of pneumonia premature infants compared with pneumonia full term infants have no significant difference within a certain gestational age range.5.The PAEE and TEE values of severe neonatal pneumonia were higher than those of light neonatal pneumonia.The energy expenditure of neonatal pneumonia was greater when the disease was more severe.