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Background  Little is known with respect to the metabolic response and the requirements of infected newborns. Moreover, the nutritional needs and particularly the energy metabolism of newborns with sepsis are controversial matter. In this investigation we aimed to evaluate the rest energy expenditure (REE) of newborns with bacterial sepsis during the acute and the recovery phases.    Methods  We studied nineteen neonates (27.3 ± 17.2 days old) with bacterial sepsis during the acute phase and recovery of their illness. REE was determined by indirect calorimetry and VO 2  and VCO 2  measured by gas chromatography.    Results  REE significantly increased from 49.4 ± 13.1 kcal/kg/day during the acute to 68.3 ± 10.9 kcal/kg/day during recovery phase of sepsis (P < 0.01). Similarly, VO 2  (7.4 ± 1.9  vs  10 ± 1.5 ml/kg/min) and VCO 2  (5.1 ± 1.7  vs  7.4 ± 1.5 ml/kg/min) were also increased during the course of the disease (P < 0.01).    Conclusion  REE was increased during recovery compared to the sepsis phase. REE of septic newborns should be calculated on individualized basis, bearing in mind their metabolic capabilities.

Rest energy expenditure is decreased during the acute as compared to the recovery phase of sepsis in newborns