Nutritional depletion in patients on long-term oxygen therapy and/or home mechanical ventilation

• Published in: The European respiratory journal Vol. 20; no. 1; pp. 30 - 37
• Main Authors: Cano, N.J.M, Roth, H, Court-Fortune, I, Cynober, L, Gerard-Boncompain, M, Cuvelier, A, Laaban, J-P, Melchior, J-C, Pichard, C, Raphael, J-C, Pison, C.M
• Format: Journal Article
• Language: English
• Published: England Eur Respiratory Soc 01-07-2002
• Subjects: Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Home Care Services - statistics & numerical data; Humans; Male; Middle Aged; Nutrition Disorders - epidemiology; Nutrition Disorders - etiology; Nutritional Status; Outpatients - statistics & numerical data; Oxygen Inhalation Therapy - adverse effects; Oxygen Inhalation Therapy - statistics & numerical data; Prevalence; Respiration Disorders - complications; Respiration Disorders - epidemiology; Respiration Disorders - therapy; Respiration, Artificial - adverse effects; Respiration, Artificial - statistics & numerical data; Respiratory Function Tests; Severity of Illness Index; Smoking - adverse effects; Smoking - epidemiology; Time Factors
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/09031936.02.01812001

The purpose of this study was to estimate the prevalence of malnutrition in outpatients on long-term oxygen therapy or home mechanical ventilation, to determine the relationships between malnutrition and impairment/disability and smoking and also to identify relevant tools for routine nutritional assessment. In 744 patients (M:F 1.68, aged 65+/-15 yrs) with chronic obstructive pulmonary disease (COPD, 40%), restrictive disorders (27%), mixed respiratory failure (15%), neuromuscular diseases (13%) and bronchiectasis (5%), body mass index (BMI), fat-free mass (FFM), serum albumin, transthyretin, 6-min walking test, forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and blood gases were recorded. FFM was the most sensitive parameter for detecting malnutrition, being abnormal in 53.6% of patients, while BMI was <20 in 23.2%, serum albumin <35 g x L(-1) in 20.7%, and serum transthyretin <200 mg x L(-1) in 20%. FFM depletion predominated in neuromuscular, bronchiectasis and restrictive disorders. BMI and FFM were correlated with FEV1, FVC and 6-min walking test. In multivariate analysis a BMI<20 was related to FEV1 and smoking habits, and a low FFM to smoking, FEV1 and female sex. Malnutrition is highly prevalent in home-assisted respiratory patients and is related to causal disease, forced expiratory volume in one second, smoking and disability. Fat-free mass appeared to be the most sensitive and relevant nutritional parameter according to impairment and disability.