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Journal of Parenteral and Enteral Nutrition
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Original Communications

Weekly Measurements Accurately Represent Trends in Resting Energy Expenditure in Children Undergoing Hematopoietic Stem Cell Transplantation

Debora Duro, MD, MS1, Lori J. Bechard, MEd, RD, LDN1,2, Henry A. Feldman, PhD1, Arkady Klykov, MD1, Alice O'Leary, MD1, Eva C. Guinan, MD2 and Christopher Duggan, MD, MPH1

From 1 Children's Hospital and2 Dana-Farber Cancer Institute, Boston, Massachusetts.

Address correspondence to: Christopher Duggan, MD, MPH, Clinical Nutrition Service, Division of GI/Nutrition, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115; e-mail: christopher.duggan{at}childrens.harvard.edu.

Background: Resting energy expenditure (REE) measurements are optimal for accurate assessment of energy requirements and precise provision of parenteral nutrients. We previously observed significant reduction in REE during a 4-week period in children undergoing hematopoietic stem cell transplantation (HSCT). The goal of this study was to determine if weekly REE measurements could accurately represent changes in REE in the peritransplant period compared with a more frequent standard of daily measurements. Methods: Data are presented from a previously described cohort of 37 children undergoing HSCT. We performed weekly indirect calorimetry on 25 patients; of those 25, we performed daily measurements on a convenience sample of 5 children. The time course of REE was analyzed in each sample by repeated measures regression. Results: The REE trend of the 20 weekly participants was similar to that of the 5 daily participants, reaching about 80% of predicted REE at 4 weeks posttransplant, with an average decline of 3.4% per week during 4 weeks. Conclusion: The results suggest that weekly REE measurements accurately characterize REE changes 4 weeks after HSCT compared with daily measurements. Characterization of these trends using weekly measurements may help guide clinical and nutrition care of these patients.

Key Words: Energy expenditure • parenteral nutrition • hematopoietic stem cell transplantation • pediatrics

Journal of Parenteral and Enteral Nutrition, Vol. 32, No. 4, 427-432 (2008)
DOI: 10.1177/0148607108319804
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