Jornal de Pediatria Copyright © 2008 by Sociedade Brasileira de Pediatria ORIGINALARTICLE

Objective: To assess the nutritional status of children and adolescents with bronchiolitis obliterans and to analyze associations with clinical and nutritional factors. Methods: The study included 57 patients. Nutritional status was assessed using z scores for weight/age, stature/ age, weight/stature in children, and stature/age and body mass index percentiles in adolescents. Body composition was assessed via tricipital skin folds, subscapular skin folds, and the sumof both plus themuscular circumference of the arm; pulmonary function was also investigated in subjects over 8 years old. Results: The high percentages of malnutrition and risk for malnutrition are noteworthy: 21.7 and 17.5%, respectively. Among children, weight/age and stature/age detected higher percentages of malnutrition (21.6 and 16.2%), while weight/stature underestimated this diagnosis. Among adolescents, body mass index detected a high percentageofmalnutrition (25%)andof risk formalnutrition (20%).Bodycompositionanalysisdetected51%ofpatients with lowmuscle reserves, and themajority of patients had normal fat reserves. Compromised pulmonary function was associatedwithpoor performanceat exercise (r=0.434;p=0.024).Malnutritionand/or nutritional risk and lowmuscle reserves were significantly associated with the 6-minute walk test (p = 0.032; p = 0.030). There was no association between spirometry and the nutritional variables (p> 0.05). Conclusion: These results emphasize the need for nutritional intervention, and suggest that, in addition to using weight and height indices for nutritional assessment, it is necessary to combine these with an analysis of body composition, so that a largernumberof patientswithmalnutritionand/orat an increased risk fordevelopingmalnutrition may be identified and correctly managed. J Pediatr (Rio J). 2008;84(4):323-330: Bronchiolitis obliterans, nutritional status, body composition, anthropometry, malnutrition, spirometry