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Improving nutritional status in a pediatric cystic fibrosis center.
Pediatr Pulmonol. 2015 Jun; 50(6):544-51.PP

Abstract

BACKGROUND

The nutritional status of patients with cystic fibrosis (CF) is strongly associated with pulmonary function, respiratory status and survival. Malnutrition could result from a discrepancy between energy needs and food intake while malabsorption results from pancreatic insufficiency which occurs in 85% of people with CF.

METHODS

A quality improvement (QI) project was designed to improve the nutritional status of patients with CF with low Body Mass Index (BMI) between 3 and 19 years of age. An algorithm was developed which included clinic-based assessments of patients' nutritional status and periodic assessment by a dietitian, social worker and/or psychologist during the project. Gastrostomy tube placement and feeding was offered as a last resort to improve caloric intake.

RESULTS

173 patients seen during January-June, 2010, were included in this project. They were classified into four BMI groups and data were collected quarterly through June, 2012. The project target population (BMI percentile ≤ 24) had a median BMI percentile at the start of the project of 11.8. At the end of the project median BMI percentile was 22 (46% improvement).

CONCLUSION

Improving nutrition and BMI for patients with CF is achievable. There must be a motivated, multi-disciplinary team that includes patients and families. A patient-specific combination of interventions must be used. These interventions could be quite basic for patients with BMI percentile ≥ 25, yet more elaborate for patients with BMI percentile <25. Clinic-based algorithms such as ours can successfully improve the BMI percentile in patients with CF.

Authors+Show Affiliations

Department of Pediatrics, Division of Pediatric Pulmonology University of Michigan Hospital and Health System, Ann Arbor, Michigan.Department of Pediatrics, Division of Pediatric Pulmonology University of Michigan Hospital and Health System, Ann Arbor, Michigan.Wayne State University Medical School, Detroit, Michigan.Department of Biostatistics, University of Michigan, Michigan.Department of Pediatrics, Division of Pediatric Pulmonology University of Michigan Hospital and Health System, Ann Arbor, Michigan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25389061

Citation

Ramírez, Ixsy, et al. "Improving Nutritional Status in a Pediatric Cystic Fibrosis Center." Pediatric Pulmonology, vol. 50, no. 6, 2015, pp. 544-51.
Ramírez I, Filbrun A, Hasan A, et al. Improving nutritional status in a pediatric cystic fibrosis center. Pediatr Pulmonol. 2015;50(6):544-51.
Ramírez, I., Filbrun, A., Hasan, A., Kidwell, K. M., & Nasr, S. Z. (2015). Improving nutritional status in a pediatric cystic fibrosis center. Pediatric Pulmonology, 50(6), 544-51. https://doi.org/10.1002/ppul.23128
Ramírez I, et al. Improving Nutritional Status in a Pediatric Cystic Fibrosis Center. Pediatr Pulmonol. 2015;50(6):544-51. PubMed PMID: 25389061.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improving nutritional status in a pediatric cystic fibrosis center. AU - Ramírez,Ixsy, AU - Filbrun,Amy, AU - Hasan,Aws, AU - Kidwell,Kelley M, AU - Nasr,Samya Z, Y1 - 2014/11/11/ PY - 2014/02/11/received PY - 2014/06/04/revised PY - 2014/07/03/accepted PY - 2014/11/13/entrez PY - 2014/11/13/pubmed PY - 2016/4/14/medline KW - body mass index (BMI) KW - cystic Fibrosis KW - nutrition KW - pediatric KW - quality improvement KW - team approach SP - 544 EP - 51 JF - Pediatric pulmonology JO - Pediatr Pulmonol VL - 50 IS - 6 N2 - BACKGROUND: The nutritional status of patients with cystic fibrosis (CF) is strongly associated with pulmonary function, respiratory status and survival. Malnutrition could result from a discrepancy between energy needs and food intake while malabsorption results from pancreatic insufficiency which occurs in 85% of people with CF. METHODS: A quality improvement (QI) project was designed to improve the nutritional status of patients with CF with low Body Mass Index (BMI) between 3 and 19 years of age. An algorithm was developed which included clinic-based assessments of patients' nutritional status and periodic assessment by a dietitian, social worker and/or psychologist during the project. Gastrostomy tube placement and feeding was offered as a last resort to improve caloric intake. RESULTS: 173 patients seen during January-June, 2010, were included in this project. They were classified into four BMI groups and data were collected quarterly through June, 2012. The project target population (BMI percentile ≤ 24) had a median BMI percentile at the start of the project of 11.8. At the end of the project median BMI percentile was 22 (46% improvement). CONCLUSION: Improving nutrition and BMI for patients with CF is achievable. There must be a motivated, multi-disciplinary team that includes patients and families. A patient-specific combination of interventions must be used. These interventions could be quite basic for patients with BMI percentile ≥ 25, yet more elaborate for patients with BMI percentile <25. Clinic-based algorithms such as ours can successfully improve the BMI percentile in patients with CF. SN - 1099-0496 UR - https://www.unboundmedicine.com/medline/citation/25389061/Improving_nutritional_status_in_a_pediatric_cystic_fibrosis_center_ L2 - https://doi.org/10.1002/ppul.23128 DB - PRIME DP - Unbound Medicine ER -