Enteral tube feeding for individuals with cystic fibrosis: Cystic Fibrosis Foundation evidence-informed guidelines

Sarah Jane Schwarzenberg; Sarah E Hempstead; Catherine M McDonald; Scott W Powers; Jamie Wooldridge; Shaina Blair; Steven Freedman; Elaine Harrington; Peter J Murphy; Lena Palmer; Amy E Schrader; Kyle Shiel; Jillian Sullivan; Melissa Wallentine; Bruce C Marshall; Amanda Radmer Leonard

doi:10.1016/j.jcf.2016.08.004

Enteral tube feeding for individuals with cystic fibrosis: Cystic Fibrosis Foundation evidence-informed guidelines

J Cyst Fibros. 2016 Nov;15(6):724-735. doi: 10.1016/j.jcf.2016.08.004. Epub 2016 Sep 3.

Authors

Sarah Jane Schwarzenberg¹, Sarah E Hempstead², Catherine M McDonald³, Scott W Powers⁴, Jamie Wooldridge⁵, Shaina Blair⁶, Steven Freedman⁷, Elaine Harrington⁸, Peter J Murphy⁹, Lena Palmer¹⁰, Amy E Schrader¹¹, Kyle Shiel¹², Jillian Sullivan¹³, Melissa Wallentine¹², Bruce C Marshall², Amanda Radmer Leonard¹⁴

Affiliations

¹ University of Minnesota, Director, Pediatric Gastroenterology, Hepatology and Nutrition, University of Minnesota Masonic Children's Hospital, 2450 Riverside Ave, Minneapolis, MN 55454, United States. Electronic address: schwa005@umn.edu.
² Cystic Fibrosis Foundation, 6931 Arlington Road Suite 200, Bethesda, MD 20814, United States.
³ Primary Children's Hospital, 100 Mario Capecchi Dr, Salt Lake City, UT 84132, United States.
⁴ Department of Pediatrics and Cincinnati Children's Research Foundation, University of Cincinnati College of Medicine and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, 3333 Burnet Ave, Cincinnati, OH 45229, United States.
⁵ Saint Louis University School of Medicine, 1402 S Grand Blvd, St. Louis, MO 63104, United States.
⁶ Emory University Cystic Fibrosis Center, 1605 Chantilly Dr NE, Atlanta, GA 30324, United States.
⁷ Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, United States.
⁸ Division of Pediatric Pulmonology, Department of Pediatrics, David Geffen School of Medicine at UCLA, Mattel Children's Hospital UCLA, 757 Westwood Plaza, Los Angeles, CA 90095, United States.
⁹ Adult Cystic Fibrosis Program, Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE S 42nd St & Emile St, Omaha, NE 68198, United States.
¹⁰ Div. of Gastroenterology & Nutrition, Loyola University Chicago Stritch School of Medicine, 2160 S 1st Ave, Maywood, IL 60153, United States.
¹¹ Barnes Jewish Hospital, Washington University Adult CF Center, 1 Barnes Jewish Hospital Plaza, St. Louis, MO 63110, United States.
¹² Community Advisor to the Cystic Fibrosis Foundation, 6931 Arlington Road Suite 200, Bethesda, MD 20814, United States.
¹³ Pediatric Gastroenterology and Nutrition, University of Vermont Children's Hospital, and Department of Pediatrics, University of Vermont College of Medicine, 89 Beaumont Ave, Burlington, VT 05405, United States.
¹⁴ Advanced Nutrition Practitioner, Division of Pediatric Gastroenterology, Nutrition and Hepatology, The Johns Hopkins Children's Center, 1800 Orleans Street, Bloomberg 9306, Baltimore, MD, 21287, United States. Electronic address: aleonar1@jhmi.edu.

PMID: 27599607
DOI: 10.1016/j.jcf.2016.08.004

Abstract

Nutrition is integral to the care of individuals with cystic fibrosis (CF). Better nutritional status is associated with improved pulmonary function. In some individuals with CF, enteral tube feeding can be useful in achieving optimal nutritional status. Current nutrition guidelines do not include detailed recommendations for enteral tube feeding. The Cystic Fibrosis Foundation convened an expert panel to develop enteral tube feeding recommendations based on a systematic review of the evidence and expert opinion. These guidelines address when to consider enteral tube feeding, assessment of confounding causes of poor nutrition in CF, preparation of the patient for placement of the enteral feeding tube, management of the tube after placement and education about enteral feeding. These recommendations are intended to guide the CF care team, individuals with CF, and their families through the enteral tube feeding process.

Keywords: Cystic fibrosis; Enteral nutrition; Feeding tube; Gastrostomy; Nasojejunal tube.

Publication types

Review
Systematic Review

MeSH terms

Cystic Fibrosis* / physiopathology
Cystic Fibrosis* / therapy
Enteral Nutrition / methods*
Humans
Nutritional Status
Practice Guidelines as Topic