{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T16:19:25Z","timestamp":1774628365157,"version":"3.50.1"},"reference-count":14,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"unspecified","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["SANDER18Y7"],"award-info":[{"award-number":["SANDER18Y7"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["WALL21D0"],"award-info":[{"award-number":["WALL21D0"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2026,3,2]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although highly effective modulator therapy may reduce future gastrostomy tube (g-tube) placements, a better understanding of the benefits of g-tube placement is needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the characteristics of children with cystic fibrosis (CF) who underwent g-tube placement and determine if earlier placement is associated with improved clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort analysis of children with CF born 2003\u20132019\u2009and followed in the US CF Foundation Patient Registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 2337 children with CF (22.9% of the study cohort) who underwent g-tube placement. Compared with children with CF who did not receive a g-tube, a higher proportion of g-tube recipients were diagnosed via meconium ileus or failure to thrive, born at &lt;37 weeks\u2019 gestation or had only class I\u2013III CF transmembrane conductance regulator mutations. G-tube recipients at age 0\u20131 years who were malnourished had improved body mass index (BMI) z-scores post-placement, though moderately to severely malnourished recipients did not achieve BMI z-scores &gt;0. In contrast, only g-tube recipients at age \u22652 years who were severely malnourished achieved BMI z-scores &gt;0. For g-tube recipients at age 0\u20131 years, per cent predicted of forced expiratory volume in 1\u2009s (ppFEV1) at age 6\u20137 years was inversely correlated with malnutrition severity. In contrast, g-tube recipients at age \u22652 years had similar median ppFEV1 at age 6\u20137 years regardless of malnutrition severity, except those with severe malnutrition had slightly lower median ppFEV1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Timing of g-tube placement in children with CF, both in relation to age and severity of malnutrition, was associated with varying degrees of improvements in BMI z-scores and ppFEV1.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjresp-2025-003576","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T15:45:12Z","timestamp":1774626312000},"page":"e003576","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Registry-based study of gastrostomy tube placement and nutritional recovery in children with cystic fibrosis"],"prefix":"10.1136","volume":"13","author":[{"given":"Brittany","family":"Wall","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James E","family":"Slaven","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly A","family":"Bozic","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen M","family":"Maguiness","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clement L","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James F","family":"Chmiel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6265-6249","authenticated-orcid":false,"given":"Don B","family":"Sanders","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"2026032708450507000_13.1.e003576.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32542-3"},{"key":"2026032708450507000_13.1.e003576.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.07.044"},{"key":"2026032708450507000_13.1.e003576.3","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1513\/AnnalsATS.201504-198OC","article-title":"Early Childhood Risk Factors for Decreased FEV1 at Age Six to Seven Years in Young Children with Cystic Fibrosis","volume":"12","author":"Sanders","year":"2015","journal-title":"Ann Am Thorac Soc"},{"key":"2026032708450507000_13.1.e003576.4","first-page":"377","article-title":"Early life weight recovery and maintenance of adequate growth through age 6 are associated with better pulmonary status at age 12 in children with CF","volume":"47","author":"Sanders","year":"2012","journal-title":"Pediatr Pulmonol"},{"key":"2026032708450507000_13.1.e003576.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.08.040"},{"key":"2026032708450507000_13.1.e003576.6","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-3089"},{"key":"2026032708450507000_13.1.e003576.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2008.02.020"},{"key":"2026032708450507000_13.1.e003576.8","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.jcf.2016.08.004","article-title":"Enteral tube feeding for individuals with cystic fibrosis: Cystic Fibrosis Foundation evidence-informed guidelines","volume":"15","author":"Schwarzenberg","year":"2016","journal-title":"J Cyst Fibros"},{"key":"2026032708450507000_13.1.e003576.9","unstructured":"Cystic Fibrosis Foundation . Annual data report. Bethesda, MD, 2024."},{"key":"2026032708450507000_13.1.e003576.10","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.jcf.2018.01.004","article-title":"The effect of enteral tube feeding in cystic fibrosis: A registry based study","volume":"17","author":"Libeert","year":"2018","journal-title":"J Cyst Fibros"},{"key":"2026032708450507000_13.1.e003576.11","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1016\/j.jcf.2024.01.007","article-title":"An emotional journey: caregiver experiences with gastrostomy tube decision-making for children with cystic fibrosis","volume":"23","author":"Dickinson","year":"2024","journal-title":"J Cyst Fibros"},{"key":"2026032708450507000_13.1.e003576.12","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201511-781OC"},{"key":"2026032708450507000_13.1.e003576.13","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1177\/0884533616671861","article-title":"Diagnosing Pediatric Malnutrition","volume":"32","author":"Bouma","year":"2017","journal-title":"Nutr Clin Pract"},{"key":"2026032708450507000_13.1.e003576.14","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00080312"}],"container-title":["BMJ Open Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjresp-2025-003576","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T15:45:14Z","timestamp":1774626314000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopenrespres.bmj.com\/lookup\/doi\/10.1136\/bmjresp-2025-003576"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3,27]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bmjresp-2025-003576"],"URL":"https:\/\/doi.org\/10.1136\/bmjresp-2025-003576","relation":{},"ISSN":["2052-4439"],"issn-type":[{"value":"2052-4439","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}