title: Energy balance during acute respiratory exacerbations in children with cystic fibrosis.
abstract: Acute respiratory exacerbations have been proposed to contribute to the negative energy balance which causes undernutrition in cystic fibrosis. However, no studies have measured their effect on all components of energy balance. The aim of this study was to measure the effect of an acute respiratory exacerbation on energy balance. Fourteen children (six females, eight males, mean+/-SD age 9.9+/-2.4 yrs) were studied when well and during the course of an acute respiratory exacerbation treated with intravenous antimicrobial therapy. The total energy expenditure was measured using the doubly-labelled water method, resting energy expenditure by ventilated hood indirect calorimetry, energy intake by household measures records, and fat malabsorption from measurements of dietary fat intake and faecal fat output. The exacerbation was associated with a significant reduction in energy intake (mean paired difference 47 kJ x kg of body weight(-1) x day(-1), p<0.01). Changes in fat malabsorption and resting energy expenditure were negligible. The absence of significant changes in body weight and composition, together with the trend towards lower total energy expenditure, suggested no marked negative energy balance during the exacerbation. In conclusion, treatment of acute respiratory exacerbation with intravenous antimicrobial therapy represents a relatively minor challenge to energy balance and nutritional status in children with cystic fibrosis.
authors.affiliation: Dept of Human Nutrition, Royal Hospital for Sick Children, University of Glasgow, Scotland.
authors.forename: J J
authors.initials: JJ
authors.lastname: Reilly
authors.forename: J M
authors.initials: JM
authors.lastname: Ralston
authors.forename: J Y
authors.initials: JY
authors.lastname: Paton
authors.forename: C A
authors.initials: CA
authors.lastname: Edwards
authors.forename: L T
authors.initials: LT
authors.lastname: Weaver
authors.forename: J
authors.initials: J
authors.lastname: Wilkinson
authors.forename: T J
authors.initials: TJ
authors.lastname: Evans
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents; D001835:Body Weight; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D004041:Dietary Fats / Q000493:pharmacokinetics; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology; D008297:Male; D009752:Nutritional Status; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D004041:Dietary Fats