Proefschrift Kerklaan

Chapter 4

For the total population, mean mREE was 48 (±9.6) kcal/kg compared to a mean caloric intake of 52 (±29) kcal/kg/day. The mean RQ was 0.88 (±0.08). Fifty percent of the children (n=39) were provided with >110% of mREE and 40% (n=31) with >120%. These children had a significant lower SD-scoreWFA (-1.8 vs -0.5, p=0.004) and, as expected, had a significant higher intake of calories (p<0.001), protein (p<0.001), fat (p<0.001), and carbohydrates (p<0.001) per kilogram compared to the children without overfeeding. Children with an SD-score WFA<-2 had a significant higher intake of calories per kilogram than children with an SD-scoreWFA≥-2 (61 vs 48 kcal/kg/d, p=0.031). The ratio caloric intake/mREE was 119% in children with an SD- score WFA<-2 and 100% in the children with an SD-score ≥-2 (p=0.091). In 22%of the children (n=17) RQwas higher than RQ macr + 0.05. Fourteen of these children (82%) were also identified as overfed according to the ratio caloric intake/mREE >120% definition. Children identified as overfed by RQ had a significant higher intake of calories (71 vs 44 kcal/ kg/d, p=0.001), protein (2.2 vs 0.9 g/kg/d, p<0.001), and fat (2.9 vs 0.9 g/kg/d, p<0.001) per kilogram and a higher ratio caloric intake/mREE (71 vs 44 kcal/kg/d, p<0.001) compared with the children with an RQ110% N = 39 Caloric intake/ mREE >120% N = 31 RQ>RQ macr +0.05 N = 17 Male sex N (%) 22 (56) 18 (58) 7 (41) Age (months) Median (IQR) 3.6 (1.0-17) 3.7 (1.0-18) 4.6 (1.7-15) Weight (kg) Median (IQR) 4.2 (3.4-8.8) 4.2 (3.4-8.8) 4.5 (3.5-8.4) SD-score WFA <-2 Mean (±SD) N (%) -1.9 (±1.8) 14 (36) -1.8 (±1.7) 11 (36) -1.8 (-3.8- -1.3) 8 (47) mREE/kg Mean (±SD) 50 (±8.3) 52 (±8.8) 50 (40-54) RQ measured Mean (±SD) 0.90 (± 0.08) 0.90 (± 0.08) 0.95 (0.93-0.98) Intake Kcal/kg/d Protein g/kg/d Fat g/kg/d Carbohydrates mg/kg/min Mean (±SD) Median (IQR) 70 (±25) 1.7 (1.0-2.5) 2.5 (1.3-3.5) 6.8 (5.4-8.6) 71 (±24) 2.1 (±0.9) 2.9 (±1.5) 6.9 (5.7-8.6) 71 (53-92) 2.2 (1.3-2.5) 2.9 (2.0-4.1) 6.5 (3.7-8.4)

Route of nutrition Exclusive EN Exclusive PN EN and PN Glucose only

N (%)

26 (67) 6 (15) 6 (15) 1 (3)

21 (68) 4 (13) 6 (19) -

11 (65) 2 (12) 4 (24) -

IQR = Interquartile Range, SD = Standard Deviation, WFA =Weight for Age, PICU = Pediatric Intensive Care Unit, mREE = measured Resting Energy Expenditure, RQ = Respiratory Quotient, EN = Enteral Nutrition, PN = Parenteral Nutrition

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