OBJECTIVE: It was our hypothesis that septic illness would alter both protein and energy metabolism in neonates, with elevations of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) serving as markers for these effects. STUDY DESIGN: 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-α, IL-6, IL-1β, 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. CONCLUSION: 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.
Bibliographical noteFunding Information:
This work was supported by the Hugh J. Andersen Foundation and the Research and Education Foundation of Children’s Health Care-St. Paul. J. D. M. is the recipient of a Steven J. Boros Memorial Fellowship.