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94 A THERMODYNAMIC MODEL TO ASSESS THE METABOLIC RATE IN NEWBORN INFANTS

Direct and indirect calorimetry are cumbersome and expensive conventional methods to assess the metabolic rate in neonates. We developed a thermodynamic model (TM) as an alternative method, whereby heat production is derived from heat loss to the environment and from heat storage, and converted into an oxygen consumption equivalent (4.83cal=1ml O2). In such a model the neonate is viewed to consist of a central cylinder (heat+torso) and a peripheral cylinder (limbs) whose volumes and surfaces are derived from body weight, length and standards. Heat loss from the surface of each cylinder is computed from its area, a combined heat transfer coefficent and the difference between mean skin and operative environmental temperature. The mean skin temperature of the central cylinder is represented by the temperature at the chest (between R nipple and xyphoid) and of the peripheral cylinder by the temperature at the calf (between knee and heel). Operative environmental temperature is approximated from incubator air and room temperature. Heat storage is computed from the rate of change of mean body temperature, the specific heat of tissue and bodyweight. The mean body temperature is derived from weighted mean skin and core temperature. The two skin, the core (esophageal) and incubator air temperature are measured by thermistors. The data are then smoothened by a special mathemetical procedure and processed by a computer based analytic-theoretical model to yield oxygen consumption. The validity of the model was evaluated at the University of Vienna, Austria.