IMPROVEMENT OF NUTRITIONAL-STATUS AND LUNG-FUNCTION AFTER LONG-TERM NOCTURNAL GASTROSTOMY FEEDINGS IN CYSTIC-FIBROSIS

We investigated weight gain and clinical course of 14 patients with cy stic fibrosis (CF), aged 7 to 23 years, who received long-term nocturn al supplemental feedings by means of percutaneous endoscopic gastrosto mies (PEGs). The patients (nine female, five male) were moderately mal nourished; the weight-for-height value was 77.8% (SD 6.4%) of the pred icted value. Lung function tests revealed severe airway obstruction; m ean vital capacity was 46.1% (SD 14.4%), and mean forced expiratory vo lume in 1 second (FEV(1)) was 30.8% (SD 12.3%) of predicted value. A n onelemental formula providing 35% of total energy from fat was used fo r nocturnal feedings. The patients received 800 to 1500 kcal per night by slow intragastric infusions. Enteric-coated pancreatic microsphere preparations were taken orally just before bedtime. After 1 year of s upplemental feedings, body weight had increased by 6.0 kg (SD 3.6 kg) and weight-for-height value by 9.0% (SD 6.1%) of predicted compared wi th baseline values. Lung function also improved significantly: vital c apacity increased by 8.2% (SD 6.3%) and FEV(1) by 3.9% (SD 4.2%) of pr edicted values (p<0.01). The total duration of nocturnal feedings was 364 months, or 26 months per patient. Nine of the fourteen patients co ntinue to use the PEG, three patients had the PEG tube removed, and tw o patients have died 21 end 23 months after PEG insertion. We conclude that nocturnal PEG feedings of malnourished patients with CF improve nutritional status and lung function without major side effects.