Pediatric Pulmonology 43:209–219 (2008) State of the Art Appetite Stimulants Use in Cystic Fibrosis

Cystic fibrosis (CF) is an autosomal recessive disease. It affectsmultiple bodyorgans. The lungs and pancreas are the most affected which results in progressive lung damage and pancreatic insufficiency.Due to thediseaseprocess,CFpatients require significantly higher caloric intake than recommended for other individuals. The nutritional goal for CF patients is to achieve normal growth and development and, once genetic potential is reached, to maintain good nutritional status throughout life. Evidence has shown that lung function is closely associated with nutritional status in CF and that nutritional status is an independent predictor of survival. Most CF patients are on a high calorie diet to help achieve normal growth and development and maintain good lung function. Inadequate caloric intake in CF can lead to malnutrition. Malnutrition in CF requires careful, multidisciplinary history taking, physical exam, and overall patient/family assessment. Only by determining the actual cause of the malnutrition can appropriate and safe therapies be used to treat it. Appetite stimulants, although efficacious in treatingmalnutrition in CF, should only be prescribed if decreased food intake secondary to inadequate appetite is the principal cause of themalnutrition and all other contributing factors have been assessed, ruled-out or treated. In this review, we attempted to summarize the use of several appetite stimulants used in CFandother diseases to improve appetite andmaximize caloric intake. Pediatr Pulmonol. 2008; 43:209–219. 2008 Wiley-Liss, Inc.