Energy balance during treated acute respiratory exacerbation in cystic fibrosis

Ralston, Judith Mary (1998) Energy balance during treated acute respiratory exacerbation in cystic fibrosis. MSc(R) thesis, University of Glasgow.

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Abstract

Prior to the present study, there was a widespread perception that acute respiratory exacerbations result in negative energy balance, which leads to undernutrition in Cystic Fibrosis (CF). This study was the first of its kind to characterise the energy balance of subjects with CF, through the simultaneous measurement of all the components of energy balance in each child: energy intake (Ei); resting metabolic rate (RMR); total energy expenditure (TEE) and faecal energy losses (Ei), together with changes in body composition during a period of treated acute respiratory exacerbation, and a 'well', clinically infection free, period. The overall aims of this study were to (i) describe energy balance in a group of children and adolescents suffering from CF with a range of respiratory disease during a treated acute respiratory exacerbation, and (ii) to determine which component(s) of the energy balance equation underwent change during the treated acute respiratory exacerbation. No noticeable effect of acute exacerbation on RMR was apparent, and while TEE was lower during the acute exacerbation, this change did not reach statistical significance. Furthermore the absence of any significant changes in the body weight and composition of the group suggests no evidence of marked negative energy balance during the treated respiratory exacerbation. Treated acute respiratory exacerbations appear now to represent less of a challenge to energy balance in CF than was previously thought. No marked negative energy balance was observed during the acute exacerbation. The findings are consistent with very recent studies which report that children with CF do not experience negative energy balance during acute respiratory exacerbations, irrespective of whether that subject is treated at home (Vic et al 1997), or within the hospital setting (Stallings et al 1998). It would appear that for certain children with CF, issues surrounding compliance with dietary treatment and pancreatic enzyme replacement therapy (PERT) may be regarded as more relevant factors in the maintenance of positive energy balance than acute respiratory exacerbation. To conclude, this study did not support the view that a treated acute respiratory exacerbation results in negative energy balance in children with CF. However it is possible that an acute exacerbation may be more important to energy balance in older subjects with more severe lung disease. (Abstract shortened by ProQuest.).

Item Type: Thesis (MSc(R))
Qualification Level: Masters
Additional Information: Adviser: J J Reilly
Keywords: Physiology
Date of Award: 1998
Depositing User: Enlighten Team
Unique ID: glathesis:1998-71353
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 10 May 2019 10:49
Last Modified: 10 May 2019 10:49
URI: http://theses.gla.ac.uk/id/eprint/71353

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