Clin Nutr Res.  2019 Oct;8(4):329-335. 10.7762/cnr.2019.8.4.329.

Nutritional Intervention of a Pediatric Patient with Congenital Bronchomalacia and Gastroesophageal Reflux Disease: a Case Report

• Shin KH
• Kim KW
• Lee SM
• Kim SY
• Kim MJ
• Sohn MH
• Lee H

• KMID: 2461100
• DOI: http://doi.org/10.7762/cnr.2019.8.4.329

Abstract

Gastroesophageal reflux disease (GERD) is closely related to respiratory issues. We reported the case about the nutrition intervention given to a male infant with congenital bronchomalacia, GERD, and recurrent pneumonia. During the first and second pediatric intensive care unit (PICU) stays, his nutrition status and nutrient intake were good. However, during the 18 days of the third PICU admission, his nutrient intake decreased to 75%-80% of his estimated calorie requirement and his Z-score for weight-for-age dropped to −1.4. We conducted nutritional interventions to improve GERD symptoms and nutritional status include avoiding overfeeding by feeding small amounts frequently, using a pre-thickened formula mixed with a high-calorie formula, and feeding through transpyloric tube. As a result, his daily nutrient intakes gradually increased and his Z-score for weight-for-age was normal. In conclusion, it is important to implement individualized intensive nutritional management to ensure adequate nutrition and growth status in infants with lung disease and GERD.

Keyword

GERD; Pneumonia; Enteral nutrition; Infant

MeSH Terms

Bronchomalacia*
Enteral Nutrition
Gastroesophageal Reflux*
Humans
Infant
Intensive Care Units
Lung Diseases
Male
Nutritional Status
Pneumonia

Figure

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  Figure 1 Summary of the patient's clinical course and nutrition intervention. PICU, pediatric intensive care unit; HOD, hospital of day; GER, gastroesophageal reflux; PN, parenteral nutrition; GI, gastrointestinal; VFSS, videofluoroscopic swallowing study.

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  Figure 2 Changes in energy intake through EN and PN. EN, enteral nutrition; PN, parenteral nutrition; HOD, hospital of day.

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  Figure 3 Change in protein intake through EN and PN. EN, enteral nutrition; PN, parenteral nutrition; HOD, hospital of day.

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  Figure 4 The patient's Z-score for weight-for-age over the course of the nutritional management. HOD, hospital of day.

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