Acute pulmonary exacerbation is not associated with increased energy expenditure in children with cystic fibrosis.
OBJECTIVE
The objective of this study was to document alterations in resting energy expenditure (REE), energy intake, and body composition that occur during admission for management of a pulmonary exacerbation in children with cystic fibrosis.


METHODS
A prospective study of 14 children with cystic fibrosis (8 male, 12.5 +/- 3.3 years) was conducted throughout a 14-day hospitalization and again 3 weeks after discharge. Repeated measures analysis of variance was used to examine the change in variables across time.


RESULTS
Significant increases were documented from days 1 to 14 in weight (37.1 +/- 13.1 kg to 38.4 +/- 13.5 kg) and pulmonary function (forced expiratory volume in 1 second: 67.6% +/- 19.8% to 78.5% +/- 24.5%). Energy intake was not different between hospitalization and follow-up and averaged 175% of the Recommended Dietary Allowance. REE on day 1 was elevated (122% +/- 11% predicted); however, when expressed with fat free mass as a covariate, no significant changes were noted in REE throughout the eight measurements.


CONCLUSIONS
These data suggest that an acute pulmonary exacerbation is not associated with an increase above a subject's baseline REE in children with cystic fibrosis with mild to moderate lung disease. Management of an acute pulmonary exacerbation should be associated with sustained improvement in pulmonary function and nutritional status; in contrast, weight loss or failure to improve pulmonary function should be seen as atypical.
Stallings
V A
VA
The Cystic Fibrosis Center, Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania School of Medicine, 19104, USA.
Fung
E B
EB
Hofley
P M
PM
Scanlin
T F
TF
D000208:Acute Disease; D000293:Adolescent; D001481:Basal Metabolism; D001823:Body Composition; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000378:metabolism*; D002149:Energy Intake; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D009748:Nutrition Disorders / Q000150:complications; D009752:Nutritional Status; D011446:Prospective Studies; D012129:Respiratory Function Tests