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Current Nutrition Reports

, Volume 6, Issue 3, pp 291–298 | Cite as

Nutrition Therapy in End-Stage Lung Disease

Gastroenterology, Critical Care, and Lifestyle Medicine (SA McClave, Section Editor)
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Part of the following topical collections:
  1. Topical Collection on Gastroenterology, Critical Care, and Lifestyle Medicine

Abstract

Purpose of Review

This review highlights the importance of nutrition support via counseling and oral nutrition supplements as needed in patients with end-stage lung disease. As chronic obstructive pulmonary disease, cystic fibrosis, pulmonary fibrosis are the most common chronic lung disease, the review will focus on these disease processes specifically. It will also discuss the role of nutrition in lung infections like tuberculosis, and the importance of nutrition in lung transplant.

Recent Findings

Recent evidence does indicate that nutritional support is essential in the management of patients with end-stage lung disease.

Summary

The benefits of nutrition support are greatest when combined with a pulmonary rehabilitation program. Ongoing research, however, is needed to find a solution to weight loss, in particular, the loss of fat-free body mass, as the ideal nutritional regimen for each disease process remains elusive.

Keywords

COPD Pulmonary cachexia Pulmonary fibrosis Malnutrition Cystic fibrosis End-stage lung disease Tuberculosis 

Notes

Compliance with Ethical Standards

Conflict of Interest

Loan Nguyen, Alessandra Morello Gearhart, Rodrigo Cavallazzi, and Karen Allen declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. 1.
    Wagner P. Possible mechanisms underlying the development of cachexia in COPD. Eur Respir J. 2008;31:492–501.CrossRefPubMedGoogle Scholar
  2. 2.
    Lozano R, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2010;380(9859):2095–128.CrossRefGoogle Scholar
  3. 3.
    Vandenbergh E, Van de Woestijne KP, Gyselen A. Weight changes in the terminal stages of chronic obstructive pulmonary disease. Relation to respiratory function and prognosis. Amer Rev of Resp Dis. 1967;95(4):556-66.Google Scholar
  4. 4.
    •• Collins PF, Stratton Rebecca J, Marinos E. Nutritional support in chronic obstructive pulmonary disease: a systemic review and meta-analysis. Am J Clin Nutr. 2012;95:1385–95. doi: 10.3945/ajcn.111.023499. A good subjective analysis of oral nutrition supplements for patients with COPD. CrossRefPubMedGoogle Scholar
  5. 5.
    Donahoe, M. Nutritional support in advanced lung disease. The pulmonary cachexia syndrome. Clin Chest Med. 1997;18(3): 547–61.Google Scholar
  6. 6.
    Baarends E, et al. Decreased mechanical efficiency in clinically stable patients with COPD. Thorax. 1997;52:981–6.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    American Thoracic Society/European Respiratory Society Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004;23:932–56.CrossRefGoogle Scholar
  8. 8.
    •• Global Initiative for Chronic Obstructive Lung Disease (GOLD Guidelines) 2017. PulmCCM Inc. http://pulmccm.org/main/2016/copd-review/new-2017-gold-guidelines-copd-released/ . An excellent overall review for diagnosis and management of COPD.
  9. 9.
    Tynan C, Hasse JM. Current nutrition practices in adult lung transplantation. Nutr Clin Pract. 2004;19(6):587–96.CrossRefGoogle Scholar
  10. 10.
    Hodson M. Integrating nutrition into pathways for patients with COPD. Br J Commun Nurs. 2016;21(11):548–52.CrossRefGoogle Scholar
  11. 11.
    Landbo C, et al. Prognostic value of nutritional status in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999;160:1856–61.CrossRefPubMedGoogle Scholar
  12. 12.
    Schols A, et al. Body composition and morality in chronic obstructive pulmonary disease. Am J Clin Nutr. 2005;82:53–9.PubMedGoogle Scholar
  13. 13.
    Vestbo J, Prescott E, Almdal T, et al. Body mass, fat-free body mass, and prognosis in patients with chronic obstructive pulmonary disease from a random population sample. Findings from the Copenhagen City Heart Study. Am J Respir Crit Care Med. 2006;173:79–83.Google Scholar
  14. 14.
    Ferreria IM, Brooks D, Lancasse Y, Goldstein RS. Nutritional support for individuals with COPD: a meta-analysis. Chest Med. 2000;117:671–8.Google Scholar
  15. 15.
    Ferreira I. Update nutritional support for patients with COPD. Respir Med. 2008;4:127–31.Google Scholar
  16. 16.
    Ferreira IM, Brooks D, Lacasse Y, Goldstein RS, White J. Nutritional supplementation for stable chronic obstructive pulmonary disease Cochrane Database Syst Rev. 2005;(2):CD000998.pub2.Google Scholar
  17. 17.
    Ferreira IM, Brooks D, White J, Goldstein R. Nutritional supplementation for stable chronic obstructive pulmonary disease 12 December 2012. doi:  10.1002/14651858.CD000998.pub3
  18. 18.
    Cllins Peter F, Marinos E, Rebecca S. Nutritional support and functional capacity in chronic obstructive pulmonary disease: a systemic review and meta-analysis. Respirology. 2013;18:616–29. doi: 10.1111/resp.12070.CrossRefGoogle Scholar
  19. 19.
    Vermeeren M, et al. Acute effects of different nutritional supplements on symptoms and functional capacity in patients with chronic obstructive pulmonary disease. Am J Clin Nutr. 2001;73:295–301.PubMedGoogle Scholar
  20. 20.
    Gurgun Alev A. Effects of nutritional supplementation combined with conventional pulmonary rehabilitation in muscle-wasted chronic obstructive pulmonary disease: a prospective, randomized and controlled study. Respirology. 18(3):495–500.Google Scholar
  21. 21.
    Pison C, et al. Multimodal nutritional rehabilitation improves clinical outcomes of malnourished patients with chronic respiratory failure: a randomized controlled trial. Thorax. 2001;66:953–60.CrossRefGoogle Scholar
  22. 22.
    Broekhuizen R, et al. Optimizing oral nutritional drink supplementation in chronic obstructive pulmonary disease. Br J Nutr. 2005;93:965–71.CrossRefPubMedGoogle Scholar
  23. 23.
    Donahoe M, et al. Nutritional assessment and support in chronic obstructive pulmonary disease. Clin Chest Med. 1990;11(3):487–504.PubMedGoogle Scholar
  24. 24.
    Schols A. Nutritional advances in patients with respiratory diseases. Eur Respir J. 2014;24:17–22.CrossRefGoogle Scholar
  25. 25.
    •• Steiner MC, Barton RL, Singh SJ, M.D.L. Morgan bedside methods versus dual energy X-ray absorptiometry for body composition measurement in COPD. Eur Respir J. 2002;19:626–31. doi: 10.1183/09031936.02.00279602. Good article to evaluate assessment of body composition for patients with chronic lung disease. CrossRefGoogle Scholar
  26. 26.
    Marquis K, Debigare R, Lacasse Y, et al. Midthigh muscle cross-sectional area is a better predictor of mortality than body mass index in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2002;166:809–13.CrossRefPubMedGoogle Scholar
  27. 27.
    Hamosh A, et al. Comparison of the clinical manifestations of cystic fibrosis in black and white patients. J Pediatr. 132(2):255–9.Google Scholar
  28. 28.
    Cystic Fibrosis Foundation Patient Registry: Annual Data Report to the Center Directors, 2015. https://www.cff.org/Our-Research/CF-Patient-Registry/2015-Patient-Registry-Annual-Data-Report.pdf.
  29. 29.
    Kerem B, et al. Identification of the cystic fibrosis gene: genetic analysis. Science. 1989;245:1073–80.CrossRefPubMedGoogle Scholar
  30. 30.
    Boyle MP. Adult cystic fibrosis. JAMA. 2007;298(15):1787–93.CrossRefPubMedGoogle Scholar
  31. 31.
    Stallings V, et al. Evidence-based practice recommendations for nutrition-related management of children and adults with cystic fibrosis and pancreatic insufficiency: results of a systematic review. J Am Diet Assoc. 2008;108:832–389.CrossRefPubMedGoogle Scholar
  32. 32.
    Culhane S, et al. Malnutrition in cystic fibrosis: a review. Nutr Clin Pract. 2013;28:676–83.CrossRefPubMedGoogle Scholar
  33. 33.
    Turck D, et al. ESPEN-ESPGHAN-ECFS guidelines on nutrition care for infants, children and adults with cystic fibrosis. Clin Nutr. 2016;35:557–77.CrossRefPubMedGoogle Scholar
  34. 34.
    Thaker V, et al. Recombinant growth hormone therapy for cystic fibrosis in children and young adults. Cochrane Database Syst Rev. 2013;6:CD00891.Google Scholar
  35. 35.
    Marchnd V, et al. Randomized, double-blind, placebo-controlled pilot trial of megestrol acetate in malnourished children with cystic fibrosis. J Pediatr Gastroenterol Nutr. 2000;31(3):264–9.CrossRefGoogle Scholar
  36. 36.
    Eubanks V, et al. Effects of megestrol acetate on weight gain, body composition, and pulmonary function in patients with cystic fibrosis. J Pediatr. 2002;140(4):439–44.CrossRefPubMedGoogle Scholar
  37. 37.
    Bruzzese E, et al. Intestinal inflammation is a frequent feature of cystic fibrosis and is reduced by probiotic administration. Aliment Pharmacol Ther. 2004;20:813–9.CrossRefPubMedGoogle Scholar
  38. 38.
    Bruzzese E, et al. Effect of Lactobacillus GG supplementation on pulmonary exacerbations in patients with cystic fibrosis: a pilot study. Clin Nutr. 2007;26:322–8.CrossRefPubMedGoogle Scholar
  39. 39.
    American Thoracic Society/European Respiratory Society international multidisciplinary consensus classification of the idiopathic interstitial pneumonias. 2002. 165(2): p. 277–304.Google Scholar
  40. 40.
    Wilson MS, Wynn TA. Pulmonary fibrosis: pathogenesis, etiology and regulation. Mucosal Immunol. 2009;2(2):103–21.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Fitting J-W, et al. Resting energy expenditure in interstitial lung disease. Am Rev Respir Dis. 1990;142(3):631–5.CrossRefPubMedGoogle Scholar
  42. 42.
    •• Remels AHV, et al. The mechanisms of cachexia underlying muscle dysfunction in COPD. J Appl Physiol. 2013;114(9):1253–62. Excellent scientific review of the etiology pulmonary cachexia in general. CrossRefPubMedGoogle Scholar
  43. 43.
    Nishiyama O, et al. A simple assessment of dyspnoea as a prognostic indicator in idiopathic pulmonary fibrosis. Eur Respir J. 2010;36(5):1067–72.Google Scholar
  44. 44.
    Alakhras M, et al. Body mass index and mortality in patients with idiopathic pulmonary fibrosis. Chest. 2007;131(5):1448–53.CrossRefPubMedGoogle Scholar
  45. 45.
    Gomer RH. New approaches to modulating idiopathic pulmonary fibrosis. Curr Allergy Asthma Rep. 2013;13(6):607–12.CrossRefPubMedCentralGoogle Scholar
  46. 46.
    Liu D, et al. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy, Asthma Clin Immunol. 2013;9(1):30.CrossRefGoogle Scholar
  47. 47.
    Grossman JM, et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res (Hoboken). 2010;62(11):1515–26.CrossRefGoogle Scholar
  48. 48.
    Vogelmeier CF, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med. 2017;195(5):557–82.CrossRefPubMedGoogle Scholar
  49. 49.
    Raghu G, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011;183(6):788–824.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Cegielski JP, McMurray DN. The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals. Int J Tuberc Lung Dis. 2004;8(3):286–98.PubMedGoogle Scholar
  51. 51.
    •• Si ZL, et al. Adjuvant efficacy of nutrition support during pulmonary tuberculosis treating course: systematic review and meta-analysis. Chin Med J. 2015;128(23):3219–30. Good review of nutrition support and TB. CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Kassu A, et al. Alterations in serum levels of trace elements in tuberculosis and HIV infections. Eur J Clin Nutr. 2006;60(5):580–6.CrossRefGoogle Scholar
  53. 53.
    WHO, Guideline. Nutritional care and support for patients with tuberculosis. Geneva: World Health Organization; 2013.Google Scholar
  54. 54.
    Sinclair D, et al. Nutritional supplements for people being treated for active tuberculosis. Cochrane Database Syst Rev, 2011(11):Cd006086.Google Scholar
  55. 55.
    Valapour M, et al. Lung. Am J Transplant. 2016;16(Suppl 2):141–68.CrossRefPubMedGoogle Scholar
  56. 56.
    Adegunsoye A, Strek ME, Garrity E, Guzy R, Bag R. Comprehensive Care of the Lung Transplant Patient. Chest. 2017;152(1):150-164. doi: 10.1016/j.chest.2016.10.001
  57. 57.
    Lederer DJ, et al. Obesity and underweight are associated with an increased risk of death after lung transplantation. Am J Respir Crit Care Med. 2009;180(9):887–95.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Efthimou J, Fleming J, Gomes C, Spiro SG. The effect of supplementary oral nutrition in poorly nourished patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1988;137:1075–82.CrossRefGoogle Scholar
  59. 59.
    Egan TM, et al. Development of the new lung allocation system in the United States. Am J Transplant. 2006;6(5 Pt 2):1212–27.CrossRefPubMedGoogle Scholar
  60. 60.
    Forli L, et al. Dietary support to underweight patients with end-stage pulmonary disease assessed for lung transplantation. Respiration. 2001;68(1):51–7.CrossRefPubMedGoogle Scholar
  61. 61.
    Habedank D, et al. Reversibility of cachexia after bilateral lung transplantation. Int J Cardiol. 2009;133(1):46–50.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Section of Pulmonary and Critical CareUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA
  2. 2.Division of Pulmonary, Critical Care, and Sleep DisordersUniversity of LouisvilleLouisvilleUSA

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