Beth Haliburton1, Marialena Mouzaki2, Monping Chiang3, Vikki Scaini4, Margaret Marcon5, Theo J Moraes6, Priscilla P Chiu7. 1. Department of Surgery, Division of Pediatric General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada. Electronic address: beth.haliburton@sickkids.ca. 2. Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada. Electronic address: marialena.mouzaki@sickkids.ca. 3. Department of Surgery, Division of Pediatric General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada. Electronic address: monping.chaing@sickkids.ca. 4. Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada. Electronic address: Vikki.scaini@sickkids.ca. 5. Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada. Electronic address: peggy.marcon@sickkids.ca. 6. Department of Pediatrics, Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada. Electronic address: theo.moreas@sickkids.ca. 7. Department of Surgery, Division of Pediatric General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada. Electronic address: priscilla.chiu@sickkids.ca.
Abstract
BACKGROUND: Failure to thrive (FTT) is well documented among congenital diaphragmatic hernia (CDH) survivors ≤3years of age, but its etiology, severity, and persistence beyond this age require further elucidation. METHODS: We conducted a single-center, retrospective study assessing anthropometrics, measured energy expenditure, and feeding tube (FT) use of 5-17 year olds in our multidisciplinary CDH clinic since January 2001. We stratified clinic visits based on age A: 5.0-6.9, B: 7.0-9.9, C: 10.0-14.9, and D: 15-17.9years. RESULTS: One hundred sixteen patients with 376 outpatient visits were reviewed. Anthropometric z-scores were below zero and did not vary across age cohorts. FTT and growth stunting each occurred in 14% of clinic visits. FTs inserted during infancy occurred in 25% of patients, and 60% remained by age 7years. In cohort A, those with FTs were lighter and shorter than those without (p<0.05) but had similar BMIs. FTT incidence was higher in the FT group (p=0.020), but FTs were present in only 30% of those with FTT. Indirect calorimetry revealed increased energy expenditure in 58% of patients. CONCLUSIONS: Failure to thrive continues in long-term CDH survivors, FTs may not improve incidence of FTT. Increased energy expenditure may play a role.
BACKGROUND: Failure to thrive (FTT) is well documented among congenital diaphragmatic hernia (CDH) survivors ≤3years of age, but its etiology, severity, and persistence beyond this age require further elucidation. METHODS: We conducted a single-center, retrospective study assessing anthropometrics, measured energy expenditure, and feeding tube (FT) use of 5-17 year olds in our multidisciplinary CDH clinic since January 2001. We stratified clinic visits based on age A: 5.0-6.9, B: 7.0-9.9, C: 10.0-14.9, and D: 15-17.9years. RESULTS: One hundred sixteen patients with 376 outpatient visits were reviewed. Anthropometric z-scores were below zero and did not vary across age cohorts. FTT and growth stunting each occurred in 14% of clinic visits. FTs inserted during infancy occurred in 25% of patients, and 60% remained by age 7years. In cohort A, those with FTs were lighter and shorter than those without (p<0.05) but had similar BMIs. FTT incidence was higher in the FT group (p=0.020), but FTs were present in only 30% of those with FTT. Indirect calorimetry revealed increased energy expenditure in 58% of patients. CONCLUSIONS: Failure to thrive continues in long-term CDH survivors, FTs may not improve incidence of FTT. Increased energy expenditure may play a role.
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