Predictive Clinical Value of Nutritional Assessment Factors in COPD

Braun, Sheldon R.; Dixon, Russell M.; Keim, Nancy L.; Luby, Margaret; Anderegg, A; Shrago, Earl

doi:10.1378/chest.85.3.353

Cited by 57 publications

(13 citation statements)

References 10 publications

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“…1). Most studies [2,3,7,[5][6][7][8][9][10][11][12][13][14][15][16][17][18] have examined stable, non-LTOT and/or HMV COPD outpatients. Very few studies [6,19] have been specifically devoted to the nutritional status of COPD patients on LTOT and/or HMV.…”

Section: Discussionmentioning

confidence: 99%

Nutritional depletion in patients on long-term oxygen therapy and/or home mechanical ventilation

Cano¹,

Roth²,

Court-Fortuné³

et al. 2002

European Respiratory Journal

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The purpose of this study was to estimate the prevalence of malnutrition in outpatients on long-term oxygen therapy or home mechanical ventilation, to determine the relationships between malnutrition and impairment/disability and smoking and also to identify relevant tools for routine nutritional assessment.In 744 patients (M:F 1.68, aged 65¡15 yrs) with chronic obstructive pulmonary disease (COPD, 40%), restrictive disorders (27%), mixed respiratory failure (15%), neuromuscular diseases (13%) and bronchiectasis (5%), body mass index (BMI), fatfree mass (FFM), serum albumin, transthyretin, 6-min walking test, forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and blood gases were recorded.FFM was the most sensitive parameter for detecting malnutrition, being abnormal in 53.6% of patients, while BMI was v20 in 23.2%, serum albumin v35 g?L -1 in 20.7 %, and serum transthyretin v200 mg?L -1 in 20%. FFM depletion predominated in neuromuscular, bronchiectasis and restrictive disorders. BMI and FFM were correlated with FEV1, FVC and 6-min walking test. In multivariate analysis a BMIv20 was related to FEV1 and smoking habits, and a low FFM to smoking, FEV1 and female sex.Malnutrition is highly prevalent in home-assisted respiratory patients and is related to causal disease, forced expiratory volume in one second, smoking and disability. Fatfree mass appeared to be the most sensitive and relevant nutritional parameter according to impairment and disability.

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Section: Discussionmentioning

confidence: 99%

Nutritional depletion in patients on long-term oxygen therapy and/or home mechanical ventilation

Cano¹,

Roth²,

Court-Fortuné³

et al. 2002

European Respiratory Journal

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show abstract

“…Energy intake has also been shown to be of importance for morbidity in COPD patients. In a study by Braun et al [4], nonhospitalized patients with severe depletion of body fat ingested significantly more calories per kilogram than the severely depleted patients requiring hospitalization in the next 6-12 months, suggesting that increased energy intake has a protective effect. The calorie and protein intake levels were found to be highest in COPD patients with the greatest weight loss and greatest degree of airway obstruction [5].…”

Section: Introductionmentioning

confidence: 99%

A Study of Intensified Dietary Support in Underweight Candidates for Lung Transplantation

Førli¹,

Bjørtuft²,

Vatn³

et al. 2001

Ann Nutr Metab

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Background: No data is available on dietary intervention in candidates for lung transplantation and on the effect of different strategies for dietary support in this cohort. Aim: We therefore wanted to evaluate the effects of intensified nutritional support compared with simple support on energy intake and nutritional status. Method: Our participants were underweight (n = 42) and normal-weight (control group, n = 29) candidates for lung transplantation. The underweight patients were randomized into two groups. Group A received intensified dietary counselling, ready-made liquid nutritional supplements free of charge and regular follow-ups, while group B received only one session of individual dietary counselling, no supplements and no follow-ups. Results: The mean intervention time was 21 weeks. Groups A and B both increased their energy intake and gained weight. Group A increased their energy intake from a median of 8.7 to 10.1 MJ (p < 0.01 compared with the control group after intervention) and gained a mean of 2.9 kg body weight (95% CI 1.2; 4.7, p = 0.005 compared with the control group), while group B increased from 7.4 to 10.8 MJ (p = 0.005) and gained 2.3 kg (1.2; 3.3, p = 0.002). Only group B increased their fat-free mass. In this group, an increase in O₂ saturation and a decrease in PaCO₂ were suggested. None of the groups improved its physical performance. Conclusion: In candidates for lung transplantation we were unable to confirm the hypothesis that intensified nutritional support compared with a simple support increased compliance. Both groups achieved the goal for energy intake and gained weight.

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“…Thus, the findings of our investigation provide ad¬ ditional data to studies suggesting that nutritional factors may have an influ¬ ence on the course of pulmonary dis¬ ease. 3,31,33,34 Although these investigations re¬ garding pulmonary status show positive results, randomized, prospective con¬ trolled studies are necessary to confirm unequivocally the influence of increased energy intake on the progression of chronic lung disease. Nevertheless, our data demonstrate that energy intake can be enhanced and weight gain sus¬ tained for many years.…”

Section: Relationship Between Pulmonary Function Energy Intake and mentioning

confidence: 99%

Efficacy of a Nonrestricted Fat Diet in Patients With Cystic Fibrosis

Luder

Kattan²,

Thornton³

et al. 1989

Arch Pediatr Adolesc Med

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Predictive Clinical Value of Nutritional Assessment Factors in COPD

Cited by 57 publications

References 10 publications

Nutritional depletion in patients on long-term oxygen therapy and/or home mechanical ventilation

Nutritional depletion in patients on long-term oxygen therapy and/or home mechanical ventilation

A Study of Intensified Dietary Support in Underweight Candidates for Lung Transplantation

Efficacy of a Nonrestricted Fat Diet in Patients With Cystic Fibrosis

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