Abstract
Progressive malnutrition associated with a fall in lung function is a major clinical problem in CF patients. As we failed to restore energy balance by oral supplemental feeding, a feeding gastrostomy was inserted (incisionless method) in 14 CF patients (5M/9F), mean age 13y(5-22y) with growth failure (X Ht.velocity = 74%standard, (X Wt.vel.=28%std.)malnutrition(X Wt/Ht%std.=82)marked lung disease (XFEV1=41%predicted)and steatorhoea. Overnight feeding with a semi-elemental formula (1000 Kcal) was done for up to 3.0y. Diet and medications were unchanged. Response was assessed with respect to changes in growth, body composition, and pulmonary function. Subjects were pair matched from the HSC CF data bank. There were marked changes in body comp.(total body potassium, nitrogen, fat, fat free mass) and growth rate as shown after a mean time of 1.2y (range 0.40-2.80y).
Mean Wt/Ht%std.±SD increased 2.0±2.0 in the treated group and declined 3.0±2.0 in controls(p<0.05). Mean change FEV1%pred. was -5.4 in treated patients (NS) and -13.0 in controls (p<0.01). Two of three patients who died during this study outlived their controls by 1.3 and 1.8y. We conclude that timely introduction of nutritional support in selected malnourished CF patients may delay the rate of decline in lung function seen in this group of patients. The mechanism by which nutritional rehabilitation affects pulmonary function remains to be determined.
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Patients, C., Levy, L., Pencharz, P. et al. 690 LONGTERM GASTROSTOMY FEEDING IN MALNOURISHED. Pediatr Res 19, 225 (1985). https://doi.org/10.1203/00006450-198504000-00720
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DOI: https://doi.org/10.1203/00006450-198504000-00720
