[Influence of nutritional status on development of nosocomial pneumonia in case of acute decompensation of chronic obstructive pulmonary diseases].
OBJECTIVE
The aim of this retrospective study was to assess the incidence of nutritional status on the development of nosocomial pneumonia in patients with chronic obstructive pulmonary disease (COPD) suffering an acute episode of respiratory failure requiring ventilatory assistance.


METHODS
The study included 48 patients with COPD who were hospitalized in an intensive care unit for acute respiratory failure requiring ventilatory assistance. Nutritional status was assessed within 24 hours of admission to the intensive care unit. Body weight, tricipital skin fold, brachial muscle circumference, creatinuria-waist index, plasma levels of albumin, transferrin, transthyretin and retinol-binding protein, the Multitest and lymphocyte counts were recorded. The diagnosis of nosocomial pneumonia was based on recognized criteria: occurrence more than 48 hours after admission, Andrews' criteria for bacterial pneumonia and bacteriological proof.


RESULTS
Nineteen of the 48 patients developed nosocomial pneumonia. The nutritional parameters at admission to intensive care were not significantly different between patients who developed nosocomial pneumonia and those who remained free of lung infection. The duration of ventilatory assistance and total stay in the intensive care unit were significantly longer in patients who developed nosocomial pneumonia.


CONCLUSIONS
This study showed that in patients with COPD who undergo ventilatory assistance for acute decompensation, the development of nosocomial pneumonia was not correlated with nutritional status admission.
Bady
E
E
Service de Pneumologie et Réanimation, Hôtel-Dieu, 1, place du Parvis Notre-Dame, 75181 Paris.
Rabbat
A
A
Kouchakji
B
B
Coignard
S
S
Laaban
J P
JP
D000208:Acute Disease; D000368:Aged; D015331:Cohort Studies; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology*; D003627:Data Interpretation, Statistical; D005260:Female; D006192:Haemophilus Infections / Q000175:diagnosis / Q000453:epidemiology*; D006193:Haemophilus influenzae; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008173:Lung Diseases, Obstructive / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000453:epidemiology*; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis / Q000453:epidemiology; D011023:Pneumonia, Staphylococcal / Q000175:diagnosis / Q000453:epidemiology; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000150:complications / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors