Resting energy expenditure in children with neonatal chronic lung disease and obstruction of the airways

Children with history of broncho-pulmonary dysplasia (BPD) often suffer from growth failure and lung sequelae. The main objective of this study was to test the role of pulmonary obstruction on resting energy expenditure (REE) and nutritional status in BPD. Seventy-one children with BPD (34 boys and 37 girls) and 30 controls (20 boys and 10 girls) aged 4-8 years were enrolled. Body composition was assessed by bio-impedancemetry measurements; REE was measured by indirect calorimetry. Predicted REE was calculated using the Schofield equation. The population of children with BPD was divided into three groups: children without obstruction of the airways, children with moderate obstruction of the airways, and children with severe obstruction. Children with BPD were significantly smaller and leaner than controls. Altered body composition (reduction of fat mass) was observed in BPD children that suffered from airway obstruction. REE was significantly lower in children with BPD compared to controls, but when adjusted for weight and fat-free mass no significant difference was observed irrespective of pulmonary status. Airway obstruction in children with BPD does not appear to be associated with an increased REE. Moreover altered REE could not explain the altered nutritional status that is still observed in BPD in later childhood. This supports the hypothesis that body composition and pulmonary function in BPD in later childhood are fixed sequelae originating from the neonatal period.