Chronic Obstructive Pulmonary Disease: A 2019 Evidence Analysis Center Evidence-Based Practice Guideline

Abstract

Chronic obstructive pulmonary disease (COPD) is a progressive lung disorder in which patients are at high risk for both pulmonary and systemic complications of their disease. Medical nutrition therapy by a registered dietitian nutritionist can be an integral component of lifestyle treatment targeted at maintaining and improving outcomes, such as lung function, mortality, and quality of life. The Academy of Nutrition and Dietetics (Academy) convened an expert workgroup to conduct a systematic review to update the COPD Evidence-Based Nutrition Practice Guideline. This publication outlines the Academy's Evidence Analysis Library methods used to complete the systematic review and guideline and examines the recommendations and supporting evidence. A total of 14 recommendations were developed based on evidence from eight conclusions. Using the Nutrition Care Process as a framework for practice, recommendations rated as strong included assessing and monitoring and evaluating body weight and medical nutrition therapy by a registered dietitian nutritionist. Weak recommendations included predicting resting and total energy expenditure. All other recommendations were rated as fair. These included individualizing the calorie prescription and macronutrient composition of the diet; assessing and monitoring and evaluating energy intake, serum 25-hydroxyvitamin D levels, and frequency of exacerbations; and determining need for vitamin D supplementation. Fewer than one-third of the systematic review's conclusions could be used to support the recommendations due to conflicting results or limited or no evidence available. The Evidence Analysis Library 2019 COPD Evidence-Based Nutrition Practice Guideline is a valuable resource for registered dietitian nutritionists and other health care professionals caring for those with COPD.

The efficacy and safety of high-flow nasal cannula therapy in patients with COPD and type II respiratory failure: a meta-analysis and systematic review

“…Traditional oxygen therapy uses low-flow oxygen, but some patients' hypoxia or hypercapnia are difficult to correct, and noninvasive ventilation (NIV) has gradually become the gold standard for the treatment of patients with AECOPD and type II respiratory failure [ 6 ]. However, the design of NIV masks and nasal masks has disadvantages such as facial compression, affecting patient communication, eating and sleep [ 7 , 8 ]. The poor comfort and mask intolerance can easily lead to tracheal intubation and cause NIV treatment failure [ 9 ].…”

Evaluation of energy intake by brief-type self-administered diet history questionnaire among male patients with stable/at risk for chronic obstructive pulmonary disease

“…The Academy of Nutrition and Dietetics revised the COPD evidence-based nutrition practice guideline in 2019. 36 In accordance with this guideline, the recommendation level of estimated energy requirement in patients with COPD was weak as there was little evidence on TEE for them. In addition, this guideline also proposed using the 30 kcal/kg body weight to estimate the TEE for non-obese adults with COPD.…”

Association between cognitive declines and disability in activities of daily living in older adults with COPD: evidence from the China health and retirement longitudinal study

“…IADL disability was described as difficulty associated with cleaning, cooking, shopping, financial management, taking medications and making phone calls. Participants were asked whether they had difficulty with each task in the four responses as follows: (1) No, I do not have any difficulty; (2) I have difficulty but I can still do it; (3) Yes, I have difficulty and need help; and (4) I cannot do it. Participants were categorised as having a lack of ability to perform ADL (ADL disability) if they reported difficulty or inability to complete 1 of the 12 activity items.…”

“…Chronic obstructive pulmonary disease (COPD) is a progressive chronic lung disease characterised by both pulmonary and systemic complications. 1–3 The exacerbation of COPD is associated with disability and premature mortality in ageing people. 4 5 The Global Burden of Diseases study estimates that COPD ranks within the top 10 diseases that cause disability globally, as measured by disability-adjusted life years in 2017 and caused about 3.2 million deaths worldwide.…”