Increased energy expenditure in infants with cyanotic congenital heart disease

Infants with cyanotic congenital heart disease (CCHD) often have reduced we ight gain compared with infants in control groups. Our purpose was to condu ct a longitudinal study of energy intake, resting energy expenditure (REE), and total energy expenditure (TEE) of a group of infants with CCHD. We hyp othesized that increased REE: and TEE and decreased energy intake in these infants would lead to reduced growth. Ten infants with uncorrected CCHD and 12 infants in a control group were studied at 2 weeks of age and again at 3 months. Indirect calorimetry was used to determine REE; the doubly labele d water method was used to determine TEE and intake. At 2 weeks and 3 month s of age, infants with CCHD weighed significantly less than infants in the control group. No significant difference was seen in energy intake or REE: between groups during either period. TEE was slightly but not statistically increased in the CCHD group at 2 weeks (72.6 +/- 17.4 vs 59.8 +/- 10.9 kca l/kg/d) and significantly increased at 3 months (93.6 +/- 23.3 vs 72.2 +/- 13.2 kcal/kg/d, P less than or equal to .03). We conclude that increased TE E but not increased REE:is a primary factor in the reduced growth in infant s with CCHD.