| Pulmonary function correlates in the prediction of long-term weight gain in cystic fibrosis patients with gastrostomy tube feedings. | |
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MedLine Citation:
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PMID: 9669726 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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S A Walker; D Gozal |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of pediatric gastroenterology and nutrition Volume: 27 ISSN: 0277-2116 ISO Abbreviation: J. Pediatr. Gastroenterol. Nutr. Publication Date: 1998 Jul |
Date Detail:
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Created Date: 1998-09-17 Completed Date: 1998-09-17 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8211545 Medline TA: J Pediatr Gastroenterol Nutr Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 53-6 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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HD-01072/HD/NICHD NIH HHS; MCJ-229163//PHS HHS |
| Comments/Corrections | |
Comment In:
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J Pediatr Gastroenterol Nutr. 1998 Jul;27(1):120-1
[PMID:
9669742
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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