Esophageal Atresia: Nutritional Status and Energy Metabolism to Maximize Growth Outcome

Gloria Pelizzo; Francesca Destro; Giorgio Giuseppe Orlando Selvaggio; Luciano Maestri; Margherita Roveri; Alessandra Bosetti; Barbara Borsani; Erica Pendezza; Milena Meroni; Andrea Pansini; Enrico La Pergola; Giovanna Riccipetitoni; Annalisa De Silvestri; Hellas Cena; Valeria Calcaterra

doi:10.3390/children7110228

Esophageal Atresia: Nutritional Status and Energy Metabolism to Maximize Growth Outcome

Gloria Pelizzo, Francesca Destro, Giorgio Giuseppe Orlando Selvaggio, Luciano Maestri, Margherita Roveri, Alessandra Bosetti, Barbara Borsani, Erica Pendezza, Milena Meroni, Andrea Pansini, Enrico La Pergola, Giovanna Riccipetitoni, Annalisa De Silvestri, Hellas Cena, Valeria Calcaterra

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Long-term negative sequelae of esophageal atresia (EA) may induce poor growth and impaired nutritional status in childhood. We describe the nutritional profile and energy metabolism of children with repaired EA to identify malnutrition risk factors and optimize growth management.

METHODS: Twenty-one children (>4 years) were included, and anthropometric measurements, nutritional assessment, and energy metabolism were considered. The subjects were defined as undernourished if they met BMI < -2 standard deviation (SD). To grade undernutrition, we defined the prevalence of underweight, stunting, and wasting (cut-off level of <-2 SD). Medical records were reviewed for the type of EA and surgery and perinatal data.

RESULTS: Malnutrition was detected in 28.6% of children. Underweight was detected in 23.8% of patients (all with undernutrition p < 0.01). Wasting was noted in 28.6% of patients, of these 5 children were undernourished (p < 0.001) and stunting was noticed in only one patient with malnutrition (p = 0.5). Resting expenditure energy (REE) was lower in undernourished subjects compared to subjects with adequate nutritional status (p < 0.001). Malnutrition was associated to: type of EA (p = 0.003, particularly type A and C); intervention including deferred anastomosis due to long-gap repair (p = 0.04) with/or without jejunostomy (p = 0.02), gastric pull-up (p = 0.04), primary anastomosis (p = 0.04), pyloromyotomy in long-gap (p < 0.01); small for gestational age condition (p = 0.001).

CONCLUSIONS: undernutrition risk factors, beyond the type of malformation, surgery, and perinatal factors, must be early considered to personalize nutritional programming. Energy metabolism is important to monitor the nutritional requirements. The management of nutritional issues is surely a contributory factor able to counteract the poor growth of children with EA.

Original language	English
Journal	Children (Basel, Switzerland)
Volume	7
Issue number	11
DOIs	https://doi.org/10.3390/children7110228
Publication status	Published - Nov 14 2020

Access to Document

10.3390/children7110228

Cite this

Pelizzo, G., Destro, F., Selvaggio, G. G. O., Maestri, L., Roveri, M., Bosetti, A., Borsani, B., Pendezza, E., Meroni, M., Pansini, A., La Pergola, E., Riccipetitoni, G., De Silvestri, A., Cena, H., & Calcaterra, V. (2020). Esophageal Atresia: Nutritional Status and Energy Metabolism to Maximize Growth Outcome. Children (Basel, Switzerland), 7(11). https://doi.org/10.3390/children7110228

Esophageal Atresia : Nutritional Status and Energy Metabolism to Maximize Growth Outcome. / Pelizzo, Gloria; Destro, Francesca; Selvaggio, Giorgio Giuseppe Orlando; Maestri, Luciano; Roveri, Margherita; Bosetti, Alessandra; Borsani, Barbara; Pendezza, Erica; Meroni, Milena; Pansini, Andrea; La Pergola, Enrico; Riccipetitoni, Giovanna; De Silvestri, Annalisa ; Cena, Hellas ; Calcaterra, Valeria.

In: Children (Basel, Switzerland), Vol. 7, No. 11, 14.11.2020.

Research output: Contribution to journal › Article › peer-review

Pelizzo, G, Destro, F, Selvaggio, GGO, Maestri, L, Roveri, M, Bosetti, A, Borsani, B, Pendezza, E, Meroni, M, Pansini, A, La Pergola, E, Riccipetitoni, G, De Silvestri, A , Cena, H & Calcaterra, V 2020, 'Esophageal Atresia: Nutritional Status and Energy Metabolism to Maximize Growth Outcome', Children (Basel, Switzerland), vol. 7, no. 11. https://doi.org/10.3390/children7110228

Pelizzo, Gloria ; Destro, Francesca ; Selvaggio, Giorgio Giuseppe Orlando ; Maestri, Luciano ; Roveri, Margherita ; Bosetti, Alessandra ; Borsani, Barbara ; Pendezza, Erica ; Meroni, Milena ; Pansini, Andrea ; La Pergola, Enrico ; Riccipetitoni, Giovanna ; De Silvestri, Annalisa ; Cena, Hellas ; Calcaterra, Valeria. / Esophageal Atresia : Nutritional Status and Energy Metabolism to Maximize Growth Outcome. In: Children (Basel, Switzerland). 2020 ; Vol. 7, No. 11.

@article{2063a82149b54f6aaa27301fe3c658ee,

title = "Esophageal Atresia: Nutritional Status and Energy Metabolism to Maximize Growth Outcome",

abstract = "BACKGROUND: Long-term negative sequelae of esophageal atresia (EA) may induce poor growth and impaired nutritional status in childhood. We describe the nutritional profile and energy metabolism of children with repaired EA to identify malnutrition risk factors and optimize growth management.METHODS: Twenty-one children (>4 years) were included, and anthropometric measurements, nutritional assessment, and energy metabolism were considered. The subjects were defined as undernourished if they met BMI < -2 standard deviation (SD). To grade undernutrition, we defined the prevalence of underweight, stunting, and wasting (cut-off level of <-2 SD). Medical records were reviewed for the type of EA and surgery and perinatal data.RESULTS: Malnutrition was detected in 28.6% of children. Underweight was detected in 23.8% of patients (all with undernutrition p < 0.01). Wasting was noted in 28.6% of patients, of these 5 children were undernourished (p < 0.001) and stunting was noticed in only one patient with malnutrition (p = 0.5). Resting expenditure energy (REE) was lower in undernourished subjects compared to subjects with adequate nutritional status (p < 0.001). Malnutrition was associated to: type of EA (p = 0.003, particularly type A and C); intervention including deferred anastomosis due to long-gap repair (p = 0.04) with/or without jejunostomy (p = 0.02), gastric pull-up (p = 0.04), primary anastomosis (p = 0.04), pyloromyotomy in long-gap (p < 0.01); small for gestational age condition (p = 0.001).CONCLUSIONS: undernutrition risk factors, beyond the type of malformation, surgery, and perinatal factors, must be early considered to personalize nutritional programming. Energy metabolism is important to monitor the nutritional requirements. The management of nutritional issues is surely a contributory factor able to counteract the poor growth of children with EA.",

author = "Gloria Pelizzo and Francesca Destro and Selvaggio, {Giorgio Giuseppe Orlando} and Luciano Maestri and Margherita Roveri and Alessandra Bosetti and Barbara Borsani and Erica Pendezza and Milena Meroni and Andrea Pansini and {La Pergola}, Enrico and Giovanna Riccipetitoni and {De Silvestri}, Annalisa and Hellas Cena and Valeria Calcaterra",

year = "2020",

month = nov,

day = "14",

doi = "10.3390/children7110228",

language = "English",

volume = "7",

journal = "Children (Basel, Switzerland)",

issn = "2227-9067",

publisher = "MDPI AG",

number = "11",

}

TY - JOUR

T1 - Esophageal Atresia

T2 - Nutritional Status and Energy Metabolism to Maximize Growth Outcome

AU - Pelizzo, Gloria

AU - Destro, Francesca

AU - Selvaggio, Giorgio Giuseppe Orlando

AU - Maestri, Luciano

AU - Roveri, Margherita

AU - Bosetti, Alessandra

AU - Borsani, Barbara

AU - Pendezza, Erica

AU - Meroni, Milena

AU - Pansini, Andrea

AU - La Pergola, Enrico

AU - Riccipetitoni, Giovanna

AU - De Silvestri, Annalisa

AU - Cena, Hellas

AU - Calcaterra, Valeria

PY - 2020/11/14

Y1 - 2020/11/14

N2 - BACKGROUND: Long-term negative sequelae of esophageal atresia (EA) may induce poor growth and impaired nutritional status in childhood. We describe the nutritional profile and energy metabolism of children with repaired EA to identify malnutrition risk factors and optimize growth management.METHODS: Twenty-one children (>4 years) were included, and anthropometric measurements, nutritional assessment, and energy metabolism were considered. The subjects were defined as undernourished if they met BMI < -2 standard deviation (SD). To grade undernutrition, we defined the prevalence of underweight, stunting, and wasting (cut-off level of <-2 SD). Medical records were reviewed for the type of EA and surgery and perinatal data.RESULTS: Malnutrition was detected in 28.6% of children. Underweight was detected in 23.8% of patients (all with undernutrition p < 0.01). Wasting was noted in 28.6% of patients, of these 5 children were undernourished (p < 0.001) and stunting was noticed in only one patient with malnutrition (p = 0.5). Resting expenditure energy (REE) was lower in undernourished subjects compared to subjects with adequate nutritional status (p < 0.001). Malnutrition was associated to: type of EA (p = 0.003, particularly type A and C); intervention including deferred anastomosis due to long-gap repair (p = 0.04) with/or without jejunostomy (p = 0.02), gastric pull-up (p = 0.04), primary anastomosis (p = 0.04), pyloromyotomy in long-gap (p < 0.01); small for gestational age condition (p = 0.001).CONCLUSIONS: undernutrition risk factors, beyond the type of malformation, surgery, and perinatal factors, must be early considered to personalize nutritional programming. Energy metabolism is important to monitor the nutritional requirements. The management of nutritional issues is surely a contributory factor able to counteract the poor growth of children with EA.

AB - BACKGROUND: Long-term negative sequelae of esophageal atresia (EA) may induce poor growth and impaired nutritional status in childhood. We describe the nutritional profile and energy metabolism of children with repaired EA to identify malnutrition risk factors and optimize growth management.METHODS: Twenty-one children (>4 years) were included, and anthropometric measurements, nutritional assessment, and energy metabolism were considered. The subjects were defined as undernourished if they met BMI < -2 standard deviation (SD). To grade undernutrition, we defined the prevalence of underweight, stunting, and wasting (cut-off level of <-2 SD). Medical records were reviewed for the type of EA and surgery and perinatal data.RESULTS: Malnutrition was detected in 28.6% of children. Underweight was detected in 23.8% of patients (all with undernutrition p < 0.01). Wasting was noted in 28.6% of patients, of these 5 children were undernourished (p < 0.001) and stunting was noticed in only one patient with malnutrition (p = 0.5). Resting expenditure energy (REE) was lower in undernourished subjects compared to subjects with adequate nutritional status (p < 0.001). Malnutrition was associated to: type of EA (p = 0.003, particularly type A and C); intervention including deferred anastomosis due to long-gap repair (p = 0.04) with/or without jejunostomy (p = 0.02), gastric pull-up (p = 0.04), primary anastomosis (p = 0.04), pyloromyotomy in long-gap (p < 0.01); small for gestational age condition (p = 0.001).CONCLUSIONS: undernutrition risk factors, beyond the type of malformation, surgery, and perinatal factors, must be early considered to personalize nutritional programming. Energy metabolism is important to monitor the nutritional requirements. The management of nutritional issues is surely a contributory factor able to counteract the poor growth of children with EA.

U2 - 10.3390/children7110228

DO - 10.3390/children7110228

M3 - Article

C2 - 33202530

VL - 7

JO - Children (Basel, Switzerland)

JF - Children (Basel, Switzerland)

SN - 2227-9067

IS - 11

ER -

Esophageal Atresia: Nutritional Status and Energy Metabolism to Maximize Growth Outcome

Abstract

Access to Document

Fingerprint

Cite this