ACUTE PULMONARY EXACERBATION IS NOT ASSOCIATED WITH INCREASED ENERGY-EXPENDITURE IN CHILDREN WITH CYSTIC-FIBROSIS

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 o f 14 children with cystic fibrosis (8 male, 12.5 +/- 3.3 years) was co nducted throughout a 14-day hospitalization and again 3 weeks after di scharge. Repeated measures analysis of variance was used to examine th e 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 Recomme nded Dietary Allowance. REE on day 1 was elevated (122% +/- 11% predic ted); however, when expressed with Fat free mass as a covariate, no si gnificant 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 c hildren with cystic fibrosis with mild to moderate lung disease. Manag ement of an acute pulmonary exacerbation should be associated with sus tained improvement in pulmonary function and nutritional status; in co ntrast, weight loss or failure to improve pulmonary function should be seen as atypical.