Effect of Late-Onset Sepsis on Energy Expenditure in Extremely Premature Infants

The purpose of this study was to compare total energy expenditure (TEE) in extremely premature infants during and after an episode of sepsis. We hypothesized that TEE in the sepsis group (SEP) would be higher during the septic period and higher than an age-matched control group (CTL). We further hypothesized that the TEE of the SEP group during the recovery period would be similar to that of the CTL group. The doubly labeled water method was used to determine TEE in both groups. Infant characteristics were as follows: SEP group, n = 10, gestation = 26 ± 1 wk, birth weight = 854 ± 218 g; CTL group, n = 10, gestation = 26 ± 1 wk, birth weight = 880 ± 158 g. TEE of the SEP group during the septic period was significantly greater than during the recovery period (96 ± 25 kcal/kg/d versus 55 ± 17 kcal/kg/d) and significantly greater than the CTL group during the first study period (96 ± 25 kcal/kg/d versus 67 ± 12 kcal/kg/d). TEE in the SEP group during the recovery period was similar to the CTL group. These increases in TEE may contribute to impaired growth and need to be considered when providing nutritional support for extremely premature infants.