Effects of Lung Volume Reduction Surgery for Emphysema on Oxygen Cost of Breathinga

Ambrogi

Frasca

et al. 2008

Chest

services can be found online on the World Wide Web at:The online version of this article, along with updated information and Background: Pulmonary emphysema is associated with cachexia and disregulation of the hormones regulating the glycolipid metabolism, insulin resistance, and altered substrate utilization. This study aimed at identifying the effects of lung volume reduction surgery (LVRS) on glycolipidic hormones compared to respiratory rehabilitation (RR). Methods: Thirty-three patients with moderate-to-severe emphysema who were undergoing video-assisted thoracoscopic LVRS were compared to 31 similar patients who refused the operation and followed a standardized RR program. All patients were evaluated before and 12 months after treatment for respiratory function, body composition, glycolipidic hormones, metabolic parameters, and insulin resistance, which was calculated using the homeostatic model assessment index for insulin resistance (HOMA-IR). These groups were compared to a matched healthy control population.

Section: Discussionmentioning

confidence: 69%

Effects of Lung Volume Reduction Surgery for Emphysema on Glycolipidic Hormones*

Ambrogi

Frasca

et al. 2008

Chest

“…Nezu et al 27 demonstrated that the recovery of fat-free mass was due to augmented tissue oxygen delivery subsequent to a reduction in breathing workload. Takayama et al 28 showed that the improvement of pulmonary and nutritional parameters could be related to the reduction of the oxygen cost of breathing. Our group showed that lung surgery can restore normal body weight and body composition, 29 and can improve right ventricular function.…”

Section: Discussionmentioning

confidence: 99%

Bone Mineral Density Improvement After Lung Volume Reduction Surgery for Severe Emphysema

Ambrogi

et al. 2005

Chest

The Annals of Thoracic Surgery

“…Recently, in a 3-month prospective study on end-stage malnourished emphysematous patients, Takayama and colleagues [11] showed that lung surgery, mainly unilateral, reduced energy expenditure of respiratory muscles only during exercise, by decreasing small airway obstruction and lung hyperinflation. Pulmonary function and VO 2 were measured by using a method of continuous expiratory dead space [28] while %VO 2 Resp was indirectly calculated from the measured energy expenditure and the predicted values.…”

Section: Commentmentioning

confidence: 99%

“…To date, little information is available about changes in energy expenditure and metabolism after lung volume reduction surgery [11]. We hypothesized that surgical therapy may ameliorate REE and metabolism by improving respiratory function and mechanics.…”

mentioning

confidence: 99%

Resting Energy Expenditure and Metabolic Changes After Lung Volume Reduction Surgery for Emphysema

Mineo¹,

Pompeo²,

Mineo³

et al. 2006

Background. Oxygen consumption volume (VO 2 ) and resting energy expenditure are increased in emphysema because of impaired respiratory function and mechanics, with greater oxygen cost of breathing and altered metabolism. We hypothesized that lung volume reduction surgery may improve energy expenditure and metabolism.Methods. In this 1-year prospective study, 30 patients with moderate-to-severe emphysema underwent bilateral lung volume reduction surgery; 28 similar patients, who refused operation, followed a standard respiratory rehabilitation program. Oxygen consumption volume and resting energy expenditure, both corrected for fat-free mass, VO 2 proportion of respiratory muscles (%VO 2 Resp), respiratory quotient, and energy substrate oxidation were determined by using a calorimetric chamber with indirect methods.Results. Only after surgery significant improvements resulted in 1-second forced expiratory volume (؉20.4%, p ‫؍‬ 0.009), residual volume (؊24.8%, p ‫؍‬ 0.001), diffusion-lung carbon-monoxide (؉18.4%, p ‫؍‬ 0.008), body mass index (؉5.5%, p ‫؍‬ 0.01), resting energy expenditure (؊8.2%, p ‫؍‬ 0.006), and %VO 2 Resp (؊44.1%, p ‫؍‬ 0.0008) with increase in respiratory quotient (0.79 versus 0.84,