Effect of intravenous fructose 1,6-diphosphate administration in malnourished chronic obstructive pulmonary disease patients with chronic respiratory failure.
BACKGROUND
Weight loss and skeletal muscle wasting are common in patients with chronic obstructive pulmonary disease (COPD) and can influence the course and the prognosis of COPD. Hypophosphatemia is a pathologic status often characterized by muscle weakness and is a frequent laboratory finding in these patients.


OBJECTIVE
The aim of the present study was to evaluate the effect of an organic phosphate (fructose 1,6-diphosphate, FDP) administration on respiratory performance in 45 malnourished COPD patients in stable clinical conditions.


METHODS
Physiologic evaluation including spirometry, maximal voluntary ventilation (MMV), elevated arm test, maximal mouth pressures (PImax and PEmax), respiratory response to CO(2), oxygen (PaO(2)) and carbon dioxide (PaCO(2)) arterial tension, a visual analogic scale (VAS) to measure dyspnea, and complete blood tests were done at the beginning and again at the end of the study.


RESULTS
After FDP administration, there was a significant increase in PImax (43.0 +/- 18.3 cm H(2)O before treatment vs. 49.8 +/- 14.9 cm H(2)O after treatment; p < 0.005). This did not occur in the placebo group (40.3 +/- 17.4 cm H(2)O before treatment vs. 42.6 +/- 20.1 cm H(2)O after treatment, nonsignificant). There was also a trend of VAS to decrease and of MVV to increase.


CONCLUSIONS
These results show that FDP administration may be useful in the management of malnourished COPD patients, especially in increasing their respiratory muscle strength.
Marchesani
F
F
Pneumology Department, Osimo Hospital, Ostuni Hospital, Rome, Italy.
Valerio
G
G
Dardes
N
N
Viglianti
B
B
Sanguinetti
C M
CM
D000368:Aged; D001784:Blood Gas Analysis; D001827:Body Height / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D002712:Chlorides / Q000097:blood; D018592:Cross-Over Studies; D004435:Eating; D005260:Female; D005635:Fructosediphosphates / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008173:Lung Diseases, Obstructive / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D010758:Phosphorus / Q000097:blood; D011188:Potassium / Q000097:blood; D012119:Respiration / Q000187:drug effects*; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D016896:Treatment Outcome
D002712:Chlorides; D005635:Fructosediphosphates; D010758:Phosphorus; C029063:fructose-1,6-diphosphate; D011188:Potassium