Document Detail


Long term nutritional rehabilitation by gastrostomy in Israeli patients with cystic fibrosis: clinical outcome in advanced pulmonary disease.
MedLine Citation:
PMID:  16456419     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Several studies have shown a linear correlation between nutritional status and pulmonary function in patients with cystic fibrosis. Our study aims were: 1) To evaluate the effect of nutritional supplementation via gastrostomy on nutritional, clinical, and pulmonary parameters, and 2) To identify predicting factors for success of long-term nutritional rehabilitation. METHODS: Twenty-one Israeli patients, aged 8 months to 20 years, underwent gastrostomy insertion from 1992 to 2001. All patients were pancreatic insufficient, and all carried severe mutations (W1282X in 62% of the patients). Anthropometric and clinical data were obtained for each patient: 0-12 months before and 6-12 months and 18-24 months after gastrostomy placement. Standard deviation scores (SDS) for height, weight, and body mass index as well as percent of height-appropriate body weight were calculated. RESULTS: The mean percent-of-predicted forced expiratory volume in 1 second (FEV1) decreased significantly during the first year of gastrostomy feeding (n = 16), from 44.2% +/- 13.9 to 41% +/- 13.3 (P = 0.05). However, during the second year of therapy (n = 10), a trend toward improvement was observed (from 39.4 +/- 12.1 to 41.4 +/- 16.1). Weight, and BMI z-scores as well as weight percent-of ideal body weight increased significantly. Height z-score for age decreased during the first year (from -1.9 +/- 1.3 to -2.1 +/- 1.4), However, a trend toward improvement was observed during the second year. A significant correlation was found between the change in weight z-score and height z-score during the first (r = 0.488, P = 0.016) and the second (r = 0.825, P < 0.001) years. There was no difference between compliers and noncompliers regarding height, weight, and BMI either before or after gastrostomy placement. A significant correlation between age at insertion of gastrostomy and improvement in height z-score (r = 0.52, P = 0.016) was observed. Cystic fibrosis related diabetes (n = 8) did not affect the response to supplemental feeding. CONCLUSIONS: We observed a trend toward improvement of pulmonary disease during the second year, and a significant improvement in weight, height, and BMI z-scores. Compliance, diabetes, and young age prior to tube insertion did not predict success of nutritional rehabilitation.
Authors:
Ori Efrati; Meir Mei-Zahav; Joseph Rivlin; Eitan Kerem; Hannah Blau; Asher Barak; Yoram Bujanover; Arie Augarten; Brijit Cochavi; Yaacov Yahav; Dalit Modan-Moses
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  42     ISSN:  0277-2116     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-02-03     Completed Date:  2006-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  222-8     Citation Subset:  IM    
Affiliation:
Pediatric Pulmonary Unit, the Safra Children's Hospital, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel. oriefrati@sheba.health.gov.il
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Anthropometry
Body Height / physiology
Body Mass Index
Body Weight / physiology
Child
Child, Preschool
Cystic Fibrosis / therapy*
Enteral Nutrition*
Female
Forced Expiratory Volume
Gastrostomy / methods*
Humans
Infant
Israel
Longitudinal Studies
Lung / physiopathology
Male
Nutritional Status*
Respiratory Function Tests / methods
Treatment Outcome
Weight Gain*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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