title: Impact of nutritional support on functional status during an acute exacerbation of chronic obstructive pulmonary disease.
abstract: The impact of oral nutritional supplementation during an acute exacerbation of COPD on functional status was assessed through measuring change in lung function, strength testing, and general well-being. Subjects hospitalized for an acute exacerbation of COPD (n = 33) were randomized to extra nutritional support or the regular hospital care. They consumed an additional 10 kcal/kg/d. Outcome measures were measured at 2 wk as change scores. Forced vital capacity (% predicted) improved in the treatment group as compared with the control group (+8.7% versus -3.5%, p = 0.015), and change in FEV1 was in the same direction but not significantly different (p = 0.099). There were no changes in handgrip strength or respiratory muscle strength, but there was a trend towards more improvement in the general well-being score (+11.96 versus -10.25, p = 0.066). Almost all subjects were in negative nitrogen balance, indicating muscle wasting. The degree of muscle wasting was strongly correlated with the dose of corticosteroids (r = 0.73, p < 0.005). In conclusion, it is difficult to prevent important muscle wasting in patients with COPD treated with corticosteroids, but some small gains were observed with increased dietary intake.
authors.affiliation: School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada.
authors.forename: H
authors.initials: H
authors.lastname: Saudny-Unterberger
authors.forename: J G
authors.initials: JG
authors.lastname: Martin
authors.forename: K
authors.initials: K
authors.lastname: Gray-Donald
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002149:Energy Intake; D004750:Enteral Nutrition / Q000592:standards*; D005260:Female; D005541:Forced Expiratory Volume; D018737:Hand Strength; D006304:Health Status; D006801:Humans; D007902:Length of Stay; D008173:Lung Diseases, Obstructive / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012132:Respiratory Muscles; D014797:Vital Capacity
chemical_list: D000305:Adrenal Cortex Hormones