Article type
Year
Abstract
Background: Growth failure and poor nutritional status are common features in children with chronic disease. Oral protein calorie supplements (OPCS) are often used to improve growth, weight gain and nutritional status of children with chronic disease. These products are very expensive, sometimes not well tolerated and may cause unpleasant side effects. Therefore, we have systematically reviewed randomised controlled trials (RCTs) of the use of OPCS in children with chronic disease.
Methods: A comprehensive search of the Cochrane Library (Issue 1, 2000) and Medline (1998-1999) was undertaken. Manufacturers of OPCS were contacted for information on unpublished studies and the conference proceedings from the European and American Societies for Parenteral and Enteral Nutrition were hand searched for relevant RCTs.
Results: The search identified 2105 potential papers associated with this intervention. From these, one reviewer selected 130 papers for which the abstract was obtained. Two reviewers then independently selected 39 papers referring to 28 trials for which the full reports were obtained. The full reports were checked independently by three reviewers and three trials were found to be eligible for inclusion in the review. The majority of excluded trials investigated the use of OPCS in children who were malnourished resulting from famine and /or poverty and who did not have an underlying chronic disease. The three eligible trials were all carried out on children with cystic fibrosis and only data on one outcome, from one trial, could be included in the meta-analysis. The authors of the trials have been contacted for further data.
Conclusions: No conclusions could be drawn on the efficacy of OPCS for children with chronic disease due to a lack of trials. Three trials have been identified, however all of these are in children with cystic fibrosis. Trials investigating the use of OPCS for children with chronic disease are urgently needed and until the results of such trials are available, these products should be used with caution.
Methods: A comprehensive search of the Cochrane Library (Issue 1, 2000) and Medline (1998-1999) was undertaken. Manufacturers of OPCS were contacted for information on unpublished studies and the conference proceedings from the European and American Societies for Parenteral and Enteral Nutrition were hand searched for relevant RCTs.
Results: The search identified 2105 potential papers associated with this intervention. From these, one reviewer selected 130 papers for which the abstract was obtained. Two reviewers then independently selected 39 papers referring to 28 trials for which the full reports were obtained. The full reports were checked independently by three reviewers and three trials were found to be eligible for inclusion in the review. The majority of excluded trials investigated the use of OPCS in children who were malnourished resulting from famine and /or poverty and who did not have an underlying chronic disease. The three eligible trials were all carried out on children with cystic fibrosis and only data on one outcome, from one trial, could be included in the meta-analysis. The authors of the trials have been contacted for further data.
Conclusions: No conclusions could be drawn on the efficacy of OPCS for children with chronic disease due to a lack of trials. Three trials have been identified, however all of these are in children with cystic fibrosis. Trials investigating the use of OPCS for children with chronic disease are urgently needed and until the results of such trials are available, these products should be used with caution.