The use of dietary fat in preference to carbohydrate offers the theoretic advantage of diminishing carbon dioxide production and thus the respiratory quotient, which may be beneficial for babies with chronic lung disease. Ten premature infants (birth weight (mean±SEM), 1.13±0.12 kg; postnatal age, 9±1 weeks) with bronchopulmonary dysplasia were alternately fed a high-fat and a high-carbohydrate formula each for 1 week, in randomized order. Lower rates of carbon dioxide production (6.6±0.3 versus 7.4±0.4 ml/kg per minute; p<0.05), and consequently lower respiratory quotients (0.80±0.02 versus 0.94±0.01 ml/kg per minute; p<0.005), were observed during the administration of the high-fat formula. There were no significant differences in results of pulmonary function tests with the use of either formula. Both formulas were equally well tolerated and able to promote adequate growth and normal biochemical profiles. However, weight gain was significantly greater with the administration of the high-carbohydrate formula, possibly because of an increase in the accretion of body fat. We conclude that the short-term use of high-fat formula for infants with bronchopulmonary dysplasia decreases carbon dioxide production while maintaining adequate growth and nutritional status.
Bibliographical noteFunding Information:
Provision of optimal nutritional care to hospitalized neonates often includes dietary modifications to compensate for specific metabolic processes altered by disease. The inges- Supported by grants from the Heinz Nutrition Center, Ross Laboratories, and National Institutes of Health grants No. HD 10823 and No. RR 0024. Received for publication July 6, 1993; accepted Nov. 16, 1993. Reprint requests: Gilberto R. Pereira, MD, Division of Neonatology, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104. Copyright | 1994 by Mosby-Year Book, Inc. 0022-3476/94/$3.00 + 0 9/23/52955 tion of protein, carbohydrate, and fat results in the production of energy via cellular metabolism; oxygen is consumed, and carbon dioxide, water, urea, and heat are produced. The ratio between the amounts of CO2 produced and 02