Source: Annual Congress 2002 - Chronic care and rehabilitation in the management of acute exacerbations
Disease area: Airway diseases

Abstract

In two previous studies, we observed during the first days of hospitalization a severely impaired energy balance, mainly due to a decreased energy and protein intake.
The aim of this multi-center trial was to investigate during an acute exacerbation, in a double blind, placebo controlled, randomized design the effectiveness of oral energy-, protein- and carbohydrate-rich nutritional supplements vs. placebo in depleted COPD patients.
11 COPD patients received oral liquid supplements (3x125 ml Respifor®:2.38 MJ/d) and 11 COPD patients placebo (3x125 ml vanilla flavored water:0 MJ/d). Medical therapy was standardized. Mean duration of hospitalization was 9±]2 days. Preliminary results indicate that in contrast to previous studies, all patients participating in the trial had a stable energy and protein intake throughout hospitalization resulting in a weight gain of 1.4±]1.2 kg (p<0.05) that was not different between the groups. Supplementation was feasible and did not replace or decrease intake from normal meals. Energy and protein intake in the supplemented group were respectively 126 % and 146 % of control (p<0.01). FEV1, IVC and PEF improved significantly, but were not different between the groups. The change in quadriceps muscle strength was significantly related to change in energy intake in the placebo group (r=0.9, p<0.01). The change in quadriceps muscle strength was significantly higher in the intervention group(p=0.035 vs. placebo), but this could not be explained by differences in energy and protein intake. Further studies are indicated to investigate if this improvement is related to specific nutrient modulation by the supplement.
This abstract was supported by Numico Research

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M. A. P. Vermeeren, E. F. M. Wouters, A. J. W. Geraerts, A. M. W. J. Schols (Maastricht, Veldhoven, The Netherlands). Oral nutritional supplementation during hospitalization for an acute exacerbation of chronic obstructive pulmonary disease. Eur Respir J 2002; 20: Suppl. 38, 3710

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