Document Detail


Pulmonary function correlates in the prediction of long-term weight gain in cystic fibrosis patients with gastrostomy tube feedings.
MedLine Citation:
PMID:  9669726     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Gastrostomy tube feedings have a positive effect on nutritional status and are currently recommended for cystic fibrosis patients who fall below 85% ideal weight for height. However, the impact of pulmonary function at the time of gastrostomy tube placement on long-term nutritional status has not been ascertained. METHODS: We retrospectively evaluated whether nutrition status and/or pulmonary function at gastrostomy tube placement surgery were predictive of subsequent long-term (> or =2 yrs) weight velocity. We identified 21 cystic fibrosis patients (12 male), ages 5-18 years at gastrostomy tube insertion. Patients were divided into two groups according to their weight gain response after 2 years on gastrostomy tube feeding. Responders were defined as having a positive change in weight/age z-score (deltaWAZpost) at 2 years follow-up compared to the 2 year period preceding gastrostomy tube insertion (deltaWAZpre). Nonresponders were defined as having a negative WAZpost. RESULTS: Responders had significantly better FEV1 at surgery (61 +/- 26 [SE] vs. 24 +/- 3 %pred.; p < 0.05). In responders, epsilonWAZpre was -0.37 +/- 0.08 and was -0.46 +/- 0.07 in nonresponders (p-NS). In contrast, AWAZpost was 0.92 +/- 0.11 in responders and -0.40 +/- 0.07 in nonresponders (p < 0.001). Furthermore, a significant correlation between weight/age z-score change and pulmonary function was found when FEV1 <40% predicted (r = 0.88; p < 0.004) whereas no significant correlation was present when FEV1 > or =40% predicted. CONCLUSIONS: We conclude that the long-term nutritional benefit of gastrostomy tube placement is critically dependent on pre-surgical pulmonary function. Our findings suggest that gastrostomy tube insertion in malnourished cystic fibrosis patients should be considered an early intervention rather than one of last resort.
Authors:
S A Walker; D Gozal
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  27     ISSN:  0277-2116     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-09-17     Completed Date:  1998-09-17     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  53-6     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Cystic Fibrosis / physiopathology*,  therapy
Enteral Nutrition*
Female
Forced Expiratory Volume
Gastrostomy*
Humans
Lung / physiopathology*
Male
Nutritional Status*
Retrospective Studies
Weight Gain*
Grant Support
ID/Acronym/Agency:
HD-01072/HD/NICHD NIH HHS; MCJ-229163//PHS HHS
Comments/Corrections
Comment In:
J Pediatr Gastroenterol Nutr. 1998 Jul;27(1):120-1   [PMID:  9669742 ]

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


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