Acute pulmonary exacerbation is not associated with increased energy expenditure in children with cystic fibrosis

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Abstract

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.

Study design

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. (J Pediatr 1998;132:493-9)

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