title: Nasogastric tube feeding in children with cancer: the effect of two different formulas on weight, body composition, and serum protein concentrations.
abstract: BACKGROUND
  Treatment of cancer cachexia partly involves the administration of adequate amounts of energy. The aim of this study was to assess the tolerance and efficacy of two equal volumes of tube feeding, one with a standard (1 kcal/mL) and one with a high energy density (1.5 kcal/mL), during the intensive phase of treatment.
  
  
  METHODS
  Nutritional status was assessed weekly, in 27 children with a solid tumor, by measuring weight, height, midupper arm circumference, biceps and triceps skinfold, and serum proteins. Tolerance was assessed by recording the occurrence of vomiting and by expressing the administered volume as a percentage of the required volume.
  
  
  RESULTS
  Both formulas were equally well tolerated, leading to a significantly higher energy intake in the energy-enriched formula group. In both formula groups, all anthropometric variables increased significantly (range of mean increase, 5.2% to 25.5%; p < .05) during the first 4 weeks of intervention. Between 4 and 10 weeks, variables continued to increase significantly in the energy-enriched group, resulting in adequate repletion, in contrast to the standard formula group. The concentration of serum proteins, low at initiation of tube feeding, returned to the normal range within 2 to 4 weeks with no significant differences between the two groups.
  
  
  CONCLUSIONS
  The energy-enriched formula was more effective in improving the nutritional status of children with cancer during the intensive phase of treatment than the standard formula. Intensive, protocolized administration of an energy-enriched formula should therefore be initiated as soon as one of the criteria for initiation of tube feeding is met.
authors.affiliation: Department of Pediatrics, University Hospital Nijmegen, The Netherlands. e.denbroeder@ckskg.azn.nl
authors.forename: E
authors.initials: E
authors.lastname: den Broeder
authors.forename: R J
authors.initials: RJ
authors.lastname: Lippens
authors.forename: M A
authors.initials: MA
authors.lastname: van 't Hof
authors.forename: J J
authors.initials: JJ
authors.lastname: Tolboom
authors.forename: R C
authors.initials: RC
authors.lastname: Sengers
authors.forename: A M
authors.initials: AM
authors.lastname: van den Berg
authors.forename: N B
authors.initials: NB
authors.lastname: van Houdt
authors.forename: Z
authors.initials: Z
authors.lastname: Hofman
authors.forename: W A
authors.initials: WA
authors.lastname: van Staveren
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001798:Blood Proteins / Q000032:analysis; D001823:Body Composition; D001835:Body Weight; D002100:Cachexia / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D002149:Energy Intake; D004750:Enteral Nutrition; D005526:Food, Formulated; D006801:Humans; D007223:Infant; D007441:Intubation, Gastrointestinal; D009369:Neoplasms / Q000150:complications*; D009752:Nutritional Status; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001798:Blood Proteins