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SUN-P263: Handgrip Force in Children and Adolescents with Cystic Fibrosis: Impact of Nutritional and Pulmonary Status
Perioperative care 1 Results: At the beginning of HPN the age of patients was between 2 and 221 month (range 6). At the end of the procedure the age was between 6 and 268 (range 41). Duration of HPN was between 0,5 and 221 months, range 53. Most of the patients (37) was qualified for HPN because of partial resection of small bowel. Second reason were neuromuscular bowel diseases (6), then Crohn disease (2) and other factors (4). The reasons of resections of small bowel were: intestinal torsion–6, bowel obstruction-6, necrotizing enterocolitis (NEC)-4, mesenteric torsion-4, congenital gastroschisis-4, Pagoda’s syndrome-3, intestinal atresia - 3 and others-7. Most of the patients (37) had preserved the ileocecal valve. From 10 patients who during parenteral nutrition have done intestinal anastomosis half of them weaned off HPN in the first year after the procedure, the rest-between 2 and 6 years. Patients after congenital gastroschisis despite small resections of short bowel, needed long-term parenteral nutrition (range 30 months). From 49 analyzed patients at the end of HPN 34 achieved regular weight and height according to WHO growth charts. Conclusion: The most frequent indication for HPN was resection of small bowel. Essential factors to weaned off parenteral nutrition were: length of small bowel, presence of ileocecal valve and intestinal anastomosis. Nutritional status at the end of HPN of most of the patients was satisfying. Disclosure of Interest: None declared.
SUN-P263 HANDGRIP FORCE IN CHILDREN AND ADOLESCENTS WITH CYSTIC FIBROSIS: IMPACT OF NUTRITIONAL AND PULMONARY STATUS K. Huysentruyt1 *, B. Hauser1, E. De Wachter2, A. Malfroot2, K. Van De Maele3, I. Gies3, J. De Schepper3. 1Pediatric Gastroenterology, 2Pediatric Pneumology, 3Pediatric Endocrinology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussel, Belgium Rationale: To analyze the hand grip strength (HGS) in relation to nutritional and pulmonary status in children and adolescents with cystic fibrosis (CF). Methods: Hand grip data of CF children (aged 5–15 years) having a body composition and lung function measurement at a yearly follow up were analyzed. Body fat percentage (FM%) calculated from skin fold measurements using the method of Slaughter, was expressed as centile from the NHANES IV database (FM% centile). Z-scores for weight (WFA), height (HFA), body mass index (BMI) and mid-upper arm circumference (MUAC) were calculated using Belgian reference data. HGS was expressed as a percentage of the mean value of Belgian reference data for the according age (%HGS). Forced vital capacity (FVC) and forced expiratory volumes in one second (FEV1) were expressed as % for age and body height. Results: HGS was assessed 269 times in 60 (24 female) patients (6 (10.3%) pancreas sufficient). Their mean (95% CI) WFA, HFA, BMI and MUAC z-scores were −0.60 (−0.71;−0.48), −0.38 (−0.49;−0.26), −0.58 (−0.70;−0.45) and −0.59 (−0.70;−0.47) and their median (Q1;Q3) FM% centile and FEV1 were 50 (25;50) and 97% (84.8%; 105.7). Median (Q1;Q3) %HGS was 72.4% (58.7%;85.4%). %HGS was not different according to sex ( p = 0.696) and pancreatic involvement ( p = 0.561). %HGS correlated significantly ( p < 0.001) with WFA (r = 0.517), HFA
S151 (r = 0.459), BMI (r = 0.392) and MUAC (r = 0.402) and FEV1 (r = 0.325), but not with FM% centile (ρ = 0.10; p = 0.873). Stepwise linear regression showed that %HGF was significantly (F = 35.6, p < 0.001; r2 = 0.34) predicted by HFA (β = 0.368), FVC (β = 0.181), age (β = 0.145) and BMI (β = 0.236). Conclusion: CF children and adolescents have a lower handgrip force in accordance with their nutritional status assessed by standard anthropometry, irrespective of their pulmonary status. Disclosure of Interest: None declared.
Perioperative care 1 SUN-P264 THE IMPACT OF PREOPERATIVE EXCLUSIVE ENTERAL NUTRITION IN MALNOURISHED PATIENTS WITH CROHN’s DISEASE A. S. Ferreira1 *, M. P. S. Costa1, C. Palmela2, S. Velho1, J. Torres2, S. Ouro2, G. Luisa2, M. Cravo2. 1Nutrition, 2Hospital Beatriz Angelo, Atouguia da Baleia, Portugal Rationale: Our aim was to evaluate the impact of exclusive enteral nutrition (EEN) in undernourished patients with stricturing or penetrating CD and surgical indication. Methods: Prospective study including CD patients with surgical indication admitted at our institution between January 2016 and March 2017. Patients with BMI <18.5 kg/m2, weight loss > 10% and/or serum albumin <3 g/dL received EEN supplemented with TGF beta for at least 2 weeks. Clinical (Harvey Bradshaw- Index -HBI) and laboratorial parameters were evaluated before and after EEN support. Surgical outcomes were compared with patients with adequate nutritional status who went for direct surgery. Results: 20 patients were included, mean age of 43.8 ± 17.3 years. Of these, 7 underwent direct surgery and 13 performed EEN, with compliance (higher than 75% of prescribed) in 85% of patients (n = 11). Mean preoperative EEN duration was 43.4 ± 20.4 days. In the EEN group, we observed a significant decrease in HBI mean value (9 vs 4, P < 0.001), CRP (12.2 vs 0.7 mg/dL, P = 0.003) and faecal calprotectin values (1003.1 vs 679, 3 μg/g p = 0.215); also, a significant increase in hemoglobin (12.5 vs 13.5 g/dL, P = 0.061) and albumin (3.1 vs 4.1 g/dL, P = 0.002) mean values was observed. A positive correlation between duration of EEN and HBI decrease (r = 0.809, P = 0.003) was observed. For fecal calprotectin decrease (r = 0.498, P = 0.255), as well as increase in hemoglobin (r = 0.455, P = 0.160) and albumin values (r = 0.489, P = 0.219) there was a positive but non-significant correlation. Incidence of postoperative complications (25% vs 37.5%, P = 1.000) and the postoperative hospital stay (8.0 ± 5.4 vs. 8.1 ± 4.4 days, P = 0.832) were similar in both groups. Conclusion: Preoperative EEN in undernourished patients with Crohn’s disease, decreased disease activity, possibly contributing for a better postoperative outcome. Disclosure of Interest: None declared.
SUN-P263 HANDGRIP FORCE IN CHILDREN AND ADOLESCENTS WITH CYSTIC FIBROSIS: IMPACT OF NUTRITIONAL AND PULMONARY STATUS K. Huysentruyt1 *, B. Hauser1, E. De Wachter2, A. Malfroot2, K. Van De Maele3, I. Gies3, J. De Schepper3. 1Pediatric Gastroenterology, 2Pediatric Pneumology, 3Pediatric Endocrinology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussel, Belgium Rationale: To analyze the hand grip strength (HGS) in relation to nutritional and pulmonary status in children and adolescents with cystic fibrosis (CF). Methods: Hand grip data of CF children (aged 5–15 years) having a body composition and lung function measurement at a yearly follow up were analyzed. Body fat percentage (FM%) calculated from skin fold measurements using the method of Slaughter, was expressed as centile from the NHANES IV database (FM% centile). Z-scores for weight (WFA), height (HFA), body mass index (BMI) and mid-upper arm circumference (MUAC) were calculated using Belgian reference data. HGS was expressed as a percentage of the mean value of Belgian reference data for the according age (%HGS). Forced vital capacity (FVC) and forced expiratory volumes in one second (FEV1) were expressed as % for age and body height. Results: HGS was assessed 269 times in 60 (24 female) patients (6 (10.3%) pancreas sufficient). Their mean (95% CI) WFA, HFA, BMI and MUAC z-scores were −0.60 (−0.71;−0.48), −0.38 (−0.49;−0.26), −0.58 (−0.70;−0.45) and −0.59 (−0.70;−0.47) and their median (Q1;Q3) FM% centile and FEV1 were 50 (25;50) and 97% (84.8%; 105.7). Median (Q1;Q3) %HGS was 72.4% (58.7%;85.4%). %HGS was not different according to sex ( p = 0.696) and pancreatic involvement ( p = 0.561). %HGS correlated significantly ( p < 0.001) with WFA (r = 0.517), HFA
S151 (r = 0.459), BMI (r = 0.392) and MUAC (r = 0.402) and FEV1 (r = 0.325), but not with FM% centile (ρ = 0.10; p = 0.873). Stepwise linear regression showed that %HGF was significantly (F = 35.6, p < 0.001; r2 = 0.34) predicted by HFA (β = 0.368), FVC (β = 0.181), age (β = 0.145) and BMI (β = 0.236). Conclusion: CF children and adolescents have a lower handgrip force in accordance with their nutritional status assessed by standard anthropometry, irrespective of their pulmonary status. Disclosure of Interest: None declared.
Perioperative care 1 SUN-P264 THE IMPACT OF PREOPERATIVE EXCLUSIVE ENTERAL NUTRITION IN MALNOURISHED PATIENTS WITH CROHN’s DISEASE A. S. Ferreira1 *, M. P. S. Costa1, C. Palmela2, S. Velho1, J. Torres2, S. Ouro2, G. Luisa2, M. Cravo2. 1Nutrition, 2Hospital Beatriz Angelo, Atouguia da Baleia, Portugal Rationale: Our aim was to evaluate the impact of exclusive enteral nutrition (EEN) in undernourished patients with stricturing or penetrating CD and surgical indication. Methods: Prospective study including CD patients with surgical indication admitted at our institution between January 2016 and March 2017. Patients with BMI <18.5 kg/m2, weight loss > 10% and/or serum albumin <3 g/dL received EEN supplemented with TGF beta for at least 2 weeks. Clinical (Harvey Bradshaw- Index -HBI) and laboratorial parameters were evaluated before and after EEN support. Surgical outcomes were compared with patients with adequate nutritional status who went for direct surgery. Results: 20 patients were included, mean age of 43.8 ± 17.3 years. Of these, 7 underwent direct surgery and 13 performed EEN, with compliance (higher than 75% of prescribed) in 85% of patients (n = 11). Mean preoperative EEN duration was 43.4 ± 20.4 days. In the EEN group, we observed a significant decrease in HBI mean value (9 vs 4, P < 0.001), CRP (12.2 vs 0.7 mg/dL, P = 0.003) and faecal calprotectin values (1003.1 vs 679, 3 μg/g p = 0.215); also, a significant increase in hemoglobin (12.5 vs 13.5 g/dL, P = 0.061) and albumin (3.1 vs 4.1 g/dL, P = 0.002) mean values was observed. A positive correlation between duration of EEN and HBI decrease (r = 0.809, P = 0.003) was observed. For fecal calprotectin decrease (r = 0.498, P = 0.255), as well as increase in hemoglobin (r = 0.455, P = 0.160) and albumin values (r = 0.489, P = 0.219) there was a positive but non-significant correlation. Incidence of postoperative complications (25% vs 37.5%, P = 1.000) and the postoperative hospital stay (8.0 ± 5.4 vs. 8.1 ± 4.4 days, P = 0.832) were similar in both groups. Conclusion: Preoperative EEN in undernourished patients with Crohn’s disease, decreased disease activity, possibly contributing for a better postoperative outcome. Disclosure of Interest: None declared.