title: Nutritional effects of long-term gastrostomy feedings in children with cystic fibrosis.
abstract: OBJECTIVE
  To analyze the long-term nutritional effects of supplemental gastrostomy feedings in undernourished patients with cystic fibrosis.
  
  
  METHODS
  Longitudinal, retrospective assessment of anthropometric measures before and for up to 4 years after gastrostomy.
  
  
  METHODS
  All patients at a large cystic fibrosis care center who underwent gastrostomy between 1980 and 1993 when they were at least 1 year old and were followed up for a minimum of 1 year after gastrostomy.
  
  
  METHODS
  The Mann-Whitney U test was used to compare anthropometric values measured during 4 postgastrostomy time intervals with values measured during the year preceding gastrostomy.
  
  
  RESULTS
  The 21 patients ranged in age from 1.1 to 20.8 years (median age = 7.4 years). They had mild to moderate malnutrition at the time of gastrostomy. Patients were followed up for a mean of 39 months after gastrostomy. Supplemental feedings were associated with significant improvements in weight and height percentiles for age, and in weight as a percentage of ideal weight. Improvement in weight occurred earlier than improvement in height. Among subjects followed up for at least 18 months after gastrostomy, median weight percentile for age increased from 2% for the year before gastrostomy to 12% for the period 6 to 18 months after gastrostomy (P < .001) and 19% for the period 30 to 48 months after gastrostomy (P = .002 compared with before gastrostomy). Other nutritional parameters followed similar, although less dramatic patterns. Gastrostomy feedings were well tolerated and associated with only minor complications.
  
  
  CONCLUSIONS
  Long-term gastrostomy feedings appear to be a safe and effective means of improving nutrition in malnourished patients with cystic fibrosis. Clinical dietitians should function as care managers for patients with cystic fibrosis who are receiving supplemental gastrostomy feedings.
authors.affiliation: Cystic Fibrosis Center, Children's Hospital Medical Center, Seattle, Wash. 98105, USA.
authors.forename: M
authors.initials: M
authors.lastname: Rosenfeld
authors.forename: S
authors.initials: S
authors.lastname: Casey
authors.forename: M
authors.initials: M
authors.lastname: Pepe
authors.forename: B W
authors.initials: BW
authors.lastname: Ramsey
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003550:Cystic Fibrosis / Q000150:complications* / Q000628:therapy; D019587:Dietary Supplements; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009748:Nutrition Disorders / Q000209:etiology / Q000628:therapy*; D009752:Nutritional Status; D012189:Retrospective Studies