Effect of sepsis syndrome on neonatal protein and energy metabolism.
OBJECTIVE
It was our hypothesis that septic illness would alter both protein and energy metabolism in neonates, with elevations of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-1 beta (IL-1 beta) serving as markers for these effects.


METHODS
A total of 31 infants with suspected sepsis were enrolled into four groups: septic, sick-nonseptic, healthy-nonseptic, and recovered septic infants. Degree of illness, oxygen consumption, nitrogen balance, urine 3-methylhistidine/creatinine (MeH/Cr), and TNF-alpha, IL-6, IL-1 beta, and C-reactive protein (CRP) were measured.


RESULTS
Oxygen consumption increased, while nitrogen balance decreased and MeH/Cr increased with increasing degree of illness. Nitrogen balance improved on recovery from sepsis. IL-6 and CRP levels were elevated in septic infants compared with sick-nonseptic and healthy infants.


CONCLUSIONS
Neonates experience a hypermetabolic response with increased nitrogen loss during septic illness, proportional to the degree of illness. Increased delivery of protein substrate may be nutritionally advantageous to the septic neonate.
Mrozek
J D
JD
Infant Pulmonary Research Center, Children's Health Care-St. Paul, Minneapolis, MN, USA.
Georgieff
M K
MK
Blazar
B R
BR
Mammel
M C
MC
Schwarzenberg
S J
SJ
D016207:Cytokines / Q000378:metabolism; D004734:Energy Metabolism; D006801:Humans; D007231:Infant, Newborn; D007375:Interleukin-1 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D009584:Nitrogen / Q000378:metabolism; D010101:Oxygen Consumption; D011446:Prospective Studies; D011506:Proteins / Q000378:metabolism*; D018746:Systemic Inflammatory Response Syndrome / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D011506:Proteins; D014409:Tumor Necrosis Factor-alpha; D009584:Nitrogen