Source: Annual Congress 2003 - COPD: a multicomponent disease
Disease area: Airway diseases, Respiratory infections

Abstract

Malnutrition is considered as an important factor in the development of morbidity and mortality of severe COPD patients. It is well-known that a worsening nutritional status can influence immunological function by compromising cellular-mediated immunity. We submitted 68 severe, stable COPD patients (FEV1: X= 39.6 ± 13.1 % predicted) with chronic respiratory failure (CRF) (PaO2: X= 53.27 ± 6.06 mmHg) in long term oxygen therapy (LTOT) to: bioimpedance analysis (BIA Akern) to evaluate body composition , sputum culture and anamnestic questionnaire concerning number of exacerbations and hospitalizations, days of hospitalization and bedrest during the last year. Results showed a large number of malnourished patients : 22 patients (32.3%) with phase angle <5° (bioelectric index of malnutrition); a significant indirect correlation (r: 0.22 - p<0.05) between body cellular mass (BCM) and number of exacerbations in the last year, which determine more frequent (X= 1.61± 1.5 vs 1.09± 2.2) and significantly longer periods of hospitalization (X= 23.57± 22.5 vs 14.22± 16.7 days; p< 0.05) in malnourished subjects. Furthermore, sputum culture of malnourished patients revealed a prevalence of Gram - bacteria (39% vs 13.3%). These results confirm the influence of malnutrition on depression of immuno-defence mechanisms. The increase of number and intensity of exacerbations, probably with involvement of inflammatory mediators, could influence the evolution towards chronic respiratory failure.

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Citations should be made in the following way:
F. De Benedetto, A. Del Ponte, S. Marinari, A. Spacone, F. Chiaravallotti (Chieti, Italy). Malnutrition influences exacerbations and airways bacterial colonization in COPD patients with chronic respiratory failure. Eur Respir J 2003; 22: Suppl. 45, 3378

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