Abstract 17372: Comparison of Resting Energy Expenditure With Energy Intake in Neonates With Hypoplastic Left Heart Syndrome Following Stage 1 Palliation
Bibliographic record
Abstract
Introduction: Nutrition provision and fluid administration following cardiac surgery in neonates impacts ventilator-dependent days, intensive care unit length of stay and diuretic administration. Resting energy expenditure (REE) in neonates following stage 1 palliation (S1P) for hypoplastic left heart syndrome (HLHS) has been poorly characterized and is essential to the provision of optimal nutrition. Methods: We continuously measured REE from postoperative day (POD) 0 through 7 following S1P in n=22 infants using an in-line, indirect calorimetric device (E-COVX moduleTM, GE Healthcare). Artifactual REE values were identified and filtered according to a predefined algorithm. Energy intake (EI) was abstracted from a detailed nutrition record. Results: There were no complications related to REE measurement, and 7.4% of measurements were found to be artifactual and excluded. Mean REE was 35.9 ± 10.1 kcal/kg/day on POD 0 and increased by an average of 3.1 ± 0.2 kcal/kg/day each day between POD 0 and 7 (A). Current recommended dietary allowance (RDA) estimates propose energy needs to be 108 kcal/kg/day in these patients. From POD 0-1, EI was less than REE by 18.5±4.3 kcal/kg/day, as fluid intake was primarily comprised of blood products (46.8±7.4%) and flushes (24.5±1.9%, B). From POD 2-7, EI exceeded REE by 22.6±4.4 kcal/kg/day (cumulative amount of 111 ± 7.7 kcal/kg/day over a 5 day period, C). EI from carbohydrates was disproportionately high (69.1±6.2%), and that from protein remained low (7.6±1.2% of calories, 1.53±0.3 g/kg/day, C). Conclusions: Following S1P, EI correlates poorly with measured REE, which is significantly lower than RDA estimates. This may result in excessive fluid and calorie administration in this fluid-sensitive population. Continuous measurement of REE is safe to perform and should be considered in neonates following cardiac surgery. A future trial comparing restricted EI to estimated EI in postoperative neonates is necessary.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".