Malnutrition and Disease Outcomes

  • W. Scott Butsch
  • Douglas C. Heimburger
Part of the Clinical Gastroenterology book series (CG)


Malnutrition is a significant global problem in health care. There are strong associations between malnutrition and increased morbidity and mortality and elevated health care costs. This chapter discusses malnutrition and outcomes in geriatrics, renal disease, respiratory disease, transplantation, and in the perioperative setting. Although there is substantial evidence documenting the benefits of medical nutrition therapy, more studies are needed to better quantify these benefits in not only hospitalized patients but in all who have a chronic disease.


Malnutrition Chronic Disease Outcomes 


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  1. 1.
    Seres DS, Resurreccion LB. Kwashiorkor: dysmetabolism versus malnutrition. Nutr Clin Pract 2003;18:297–301.PubMedGoogle Scholar
  2. 2.
    McClave SA, Mitoraj TE, Thielmeir KA, Greenburg RA. Differentiating subtypes (hypoalbuminemic vs marasmic) of protein-calorie malnutrition: prevalence and clinical significance in a university hospital setting. JPEN 1992;16:337–342Google Scholar
  3. 3.
    Butterworth CE. The skeleton in the hospital closet. Nutr Today 1974;9:4–8.Google Scholar
  4. 4.
    Bistrian BR, Blackburn GL, Vitale J, Cochran D, Naylor J. Prevalence of malnutrition in general medical patients. JAMA 1976;235:1567.PubMedGoogle Scholar
  5. 5.
    Coats KG, Morgan SL, Bartolucci AA, Weinsier RL. Hospital-associated malnutrition: A reevaluation 12 years later. J Am Diet Assoc 1993;93:27–33.PubMedGoogle Scholar
  6. 6.
    McWhirter JP, Pennington CR. Incidence and recognition of malnutrition in hospital. BMJ 1994;308:945–948.PubMedGoogle Scholar
  7. 7.
    Cederholm T, Jägrén C, Hellström K. Outcome of protein-energy malnutrition in elderly medical patients. Am J Med 1995;98:67–74.PubMedGoogle Scholar
  8. 8.
    Naber THJ, Schermer T, de Bree A, Nusteling K, Eggink L, Kruimel JW, Bakkeren J, van Heereveld H, Katan MB. Prevalence of malnutrition in nonsurgical hospitalized patients and its association with disease complications. Am J Clin Nutr 1997;66:1232–1239.PubMedGoogle Scholar
  9. 9.
    Mowe M, Bohmer T. The prevalence of undiagnosed protein calorie undernutrition in a population of hospitalized elderly patients. J Am Geriat Soc 1991;39:1089–1092.PubMedGoogle Scholar
  10. 10.
    Waitzberg DL, Caiaffa WT, Correia MITD. Hospital malnutrition: the Brazilian National Survey (IBRANUTRI): A study of 4,000 patients. Nutrition 2001;17:573–580.PubMedGoogle Scholar
  11. 11.
    Penié, JB. State of malnutrition in Cuban hospitals. Nutrition 2005;21:487–497.Google Scholar
  12. 12.
    Pirlich M, Schutz T, Kemps M, Luhman N, Burmester GR, Baumann G, Plauth M, Lubke HJ, Lochs H. Prevalence of malnutrition in hospitalized medical patients: impact of underlying disease. Dig Dis 2003;21:245–251.PubMedGoogle Scholar
  13. 13.
    Morley JE. Protein-energy malnutrition in older subjects. Proc Nutr Soc 1998;57:587–592.PubMedGoogle Scholar
  14. 14.
    Martyn CN, Winter PD, Coles SJ, Edington J. Effect of nutritional status on use of health care resources by patients with chronic disease living in the community. Clin Nutr 1998;17(3):119–123.PubMedGoogle Scholar
  15. 15.
    Edington J, Kon P, Martyn CN. Prevalence of malnutrition in patients in general practice. Clin Nutr 1996;15:60–63.PubMedGoogle Scholar
  16. 16.
    Edington J, Boorman J, Durrant ER, Perkins A, Giffin CV, James R, Thomson JM, Oldroyd JC, Smith JC, Torrance AD, Blackshaw V, Green S, Hill CJ, Berry C, McKenzie C, Vicca N, Ward JE, Coles SJ (The Malnutrition Prevelance Group). Prevalence of malnutrition on admission to four hospitals in England. Clin Nutr 2000;19(3):191–195.PubMedGoogle Scholar
  17. 17.
    Hill GL, Pickford I, Young GA. Malnutrition in surgical patients. An unrecognized problem. Lancet 1977;309:689–692.Google Scholar
  18. 18.
    Corish C, Flood P, Mulligan S, Kennedy NP. Prevalence of undernutrition and weight loss changes during the course of hospitalization among patients admitted to two Dublin hospitals. Proc Nutr Soc 1998;57:10A.Google Scholar
  19. 19.
    Dey, DK, Rothenberg E, Sundh V, Bosaeus I, Steen B, Body mass index, weight change, and mortality in the elderly. A 15-year longitudinal population study of 70 year olds. Eur J Clin Nutr 2001;55:482–492.PubMedGoogle Scholar
  20. 20.
    Seres DS. Surrogate nutrition markers, malnutrition, and adequacy of nutrition support. JPEN 2005;20:308–313.Google Scholar
  21. 21.
    Koretz RL. Death, morbidity and economics are the only end points for trials.[abstract] Proc Nutr Soc. 2005;64(3):277–284.PubMedGoogle Scholar
  22. 22.
    Klein S, Kinney J, Jeejeebhoy K, Alpers D, Hellerstein M, Murray M, Twomey P et al. Nutrition support in clinical practice: review of published data and recommendations for future research directions. Summary of a conference sponsored by the National Institutes of Health, American Society for Parenteral and Enteral Nutrition, and American Society for Clinical Nutrition. Am J Clin Nutr 1997;66(3):683–706.PubMedGoogle Scholar
  23. 23.
    Weinsier RL, Hunker EM, Krumdieck Cl, Butterworth CE. Hospital malnutrition: A prospective evaluation of general medical patients during the course of hospitalization. Am J Clin Nutr 1979;32:418–426.PubMedGoogle Scholar
  24. 24.
    Chima C, Barco K, Dewitt M, Maeda M, Teran, JC, Mullen K. Relationship of nutritional status to length of stay, hospital costs, and discharge status of patients hospitalized in the medicine service. J Am Dietetic Assoc 1997; 97(9):975–978.Google Scholar
  25. 25.
    Giner M, Laviano A, Meguid MM, Gleason JR. In 1995 a correlation between malnutrition and poor outcome in critically ill patients still exists. Nutrition 1996;12:23–29.PubMedGoogle Scholar
  26. 26.
    Mühlethaler R, Stuck A, Minder C, Frey B. The prognostic significance of protein-energy malnutrition in geriatric patients. Age Ageing 1995;24:193–197.PubMedGoogle Scholar
  27. 27.
    Kagansky N, Berner Y, Koren-Morag N, Perelman L, Knobler H, Levy S. Poor nutritional habits are predictors or poor outcome in very old hospitalized patients. Am J Clin Nutr 2005;82:784–791.PubMedGoogle Scholar
  28. 28.
    Dempsey DT, Mullen JL, Buzby GP. The link between nutritional status and clinical outcome: can nutritional intervention modify it? Am J Clin Nutr 1988;47(suppl):352–356.PubMedGoogle Scholar
  29. 29.
    Potter, J, Klipstein K, Reilly JJ, Roberts M. The nutritional status and clinical course of acute admissions to a geriatric unit. Age Ageing. 1995;24:131–136.PubMedGoogle Scholar
  30. 30.
    Thomas DR, Zdrowski CD, Wilson M-M, Conright K, Lewis C, Tariq S, Morley JE. Malnutrition in subacute care. Am J Clin Nutr 2002;75:308–313.PubMedGoogle Scholar
  31. 31.
    Robinson G, Goldstein M, Levine G. Impact of nutritional status on DRG length of stay. JPEN 1987;11:49–51.Google Scholar
  32. 32.
    Reilly JJ Jr, Hull SF, Albert N, Waller A, Bringardener S. Economic impact of malnutrition: a model system for hospitalized patients. JPEN 1988;12(4):371–376.Google Scholar
  33. 33.
    Gallagher-Allred, CR, Coble Voss A, Koop KL. The effect of medical nutrition therapy on malnutrition and clinical outcomes. Nutrition 1999;15:512–514.PubMedGoogle Scholar
  34. 34.
    Correia MITD, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay, and costs evaluated through a multivariate model analysis. Clin Nutr 2003;22:2–5.Google Scholar
  35. 35.
    Dzieniszewski J, Jarosz M, Szczygiel B, Dlugosz J, Marlicz K, Linke K, Lachowicz A, Ryzko-Skiba M, Orzeszko M. Nutritional status of patients hospitalised in Poland. Eur J Clin Nutr 2005;59:552–560.PubMedGoogle Scholar
  36. 36.
    Edington J, Winter PD, Coles SJ, Gale CR, Martyn CN. Outcomes of undernutrition in patients in the community with cancer or cardiovascular disease. Proc Nutr Soc 1999;58(3):655–661.PubMedGoogle Scholar
  37. 37.
    Constans T, Bacq Y, Brechot J-F, Guilmot J-L, Choutet P, Lamisse F. Protein-energy malnutrition in elderly medical patients. J Am Geriatric Soc 1992;40:263–268.Google Scholar
  38. 38.
    Sullivan DH, Morley JE, Johnson LE, Barber A, Olson JS, Stevens MR, Yamashita BD, Reinhart SP, Trotter JP, Olave XE. The GAIN (Geriatric Anorexia Nutrition) registry: the impact of appetite and weight on mortality in a long-term care population. J Nutr Health Aging 2002;6(4):275–281.PubMedGoogle Scholar
  39. 39.
    Kamath SK, Lawler M, Smith AE, et al. Hospital malnutrition. J Am Diet Assoc 1986;86:203–206.PubMedGoogle Scholar
  40. 40.
    Tobias AL, Van Itallie TB. Nutritional problems of hospitalized patients. J Am Diet Assoc; 1977;71:253–257.PubMedGoogle Scholar
  41. 41.
    Sullivan DH, Moriarty MS, Chernoff R., Lipschitz DA. Patterns of care: an analysis of the quality of nutritional care routinely provided to elderly hospitalized veterans. JPEN 1989;13:249–254.Google Scholar
  42. 42.
    Keller HH. Malnutrition in institutionalized elderly: How and why? J Am Geriatr Soc 1993;41:1212–1218.PubMedGoogle Scholar
  43. 43.
    Sullivan DH, Sun S, Walls RC. Protein-energy Undernutrition among elderly hospitalized patients: A prospective study. JAMA 1999;281(21):2013–2019.PubMedGoogle Scholar
  44. 44.
    Sullivan DH, Walls, RC. Protein-energy undernutrition and the risk of mortality within 6 years of hospital discharge. J Am Col Nutr 1998;17(6):571–578.Google Scholar
  45. 45.
    Phillips A, Shaper AG, Whincup PH. Association between serum albumin and mortality from cardiovascular disease, cancer, and other causes. Lancet 1989;2:1434–1436.PubMedGoogle Scholar
  46. 46.
    Hopkins BS, Bistrain BR, Blackburn GL. Protein-calorie management in hospitalized patients. In: Schneider HA, Anderson CE, Coursin DB (eds) Nutritional support of medical practice’’ (2nd edn). Philadelphia: Harper & Row, 1983.Google Scholar
  47. 47.
    Sullivan DH, Walls RC, Bopp MM. Protein-energy undernutrition and the risk of mortality 1 year after hospital discharge: A follow-up study. J Am Geriatric Soc 1995;43:507–512.Google Scholar
  48. 48.
    Freidmann JM, Jensen Gl, Smiciklas-Wright H, McCamish MA. Predicting early non-elective hospital readmission in nutritionally compromised older adults. Am J Clin Nutr 1997;65:1714–1720.Google Scholar
  49. 49.
    Linn, B. Malnutrition and immunocompetence in older and younger outpatients. South Med J. 1984;77(9):1098–1102.PubMedGoogle Scholar
  50. 50.
    Paillaud E, Herbaud S, Caillet P, Lejonc J-L, Campillo B, Bories P-N. Relations between undernutrition and nosocomial infections in elderly patients. Age Ageing 2005;34:619–625.PubMedGoogle Scholar
  51. 51.
    Suominen M, Muurinen S, Routasalo P, Soini H, Suur-Uski I, Peiponen A, Finne-Soveri H, Pitkala KH. Malnutrition and associated factors among aged residents in all nursing homes in Helsinki. Eur J Clin Nutr 2005;59:578–583.PubMedGoogle Scholar
  52. 52.
    Thomas, DR. ‘‘The relationship of nutrition and pressure ulcers. In: Bales CW, Ritchie CS (eds) Handbook of clinical nutrition and aging. Totowa, NJ: Humana Press Inc, 2004, 335–349.Google Scholar
  53. 53.
    Lumbers M, New SA, Gibson S, Murphy MC. Nutritional status in elderly female hip fracture patients: comparison with an age-matched home living group attending day centres. Br J Nutr 200;185(6):733–740.Google Scholar
  54. 54.
    Akner G, Cederholm T. Treatment of protein-energy malnutrition in chronic malignant disorders. Am J Clin Nutr 2001;74:6–24.PubMedGoogle Scholar
  55. 55.
    Morley JE. Anorexia of aging: physiologic and pathologic. Am J Clin Nutr.1997;66(4):760–773.PubMedGoogle Scholar
  56. 56.
    Scrimshaw NS, San Giovanni JP, Synergism on nutrition, infection and immunity: an overview. Am J Clin Nutr 1997;66:464S–77S.PubMedGoogle Scholar
  57. 57.
    Mazari L, Lesourd BM, Nutritional influences on immune responses in healthy aged persons. Mech Ageing Dev 1998;104:25–40.PubMedGoogle Scholar
  58. 58.
    Milne AC, Avenell A, Potter J. Meta-analysis: protein and energy supplementation in older people. Ann Int Med 2006;144(1):37–48.PubMedGoogle Scholar
  59. 59.
    Fiatarone Singh MA, Bernstein MA, Ryan AD, O’Neill EF, Clements KM, Evans WJ. The effect of oral nutritional supplements on habitual dietary quality and quantity in frail elders. J Nutr Health Aging 2000;4(1):5–12.PubMedGoogle Scholar
  60. 60.
    Edington, J, Barnes R, Bryan F, Dupree E, Frost G, Hickson M, Lancaster J, Mongia S, Smith J, Torrance A, West R, Pang F, Coles SJ. A prospective randomised controlled trial of nutritional supplementation in malnourished elderly in the community: clinical and health economic outcomes. Clin Nutr 2004;23:195–204.PubMedGoogle Scholar
  61. 61.
    Lauque S, Arnaud-Battandier F, Mansourian R, Guigoz Y, Paintin M, Nourhashemi F, Vellas B. Protein-energy oral supplementation in malnourished nursing-home residents. A controlled trial. Age Ageing. 2000;29(1):51–56.PubMedGoogle Scholar
  62. 62.
    Yeh SS, Hafner A, Chang CK, Levine DM, Parker TS, Schuster MW. Risk factors relating blood markers of inflammation and nutritional status to survival in cachectic geriatric patients in a randomized clinical trial. J Am Geriatr Soc. 2004;52(10):1708–1712.PubMedGoogle Scholar
  63. 63.
    Morley JE. Orexigenic and anabolic agents. Clin Geriatr Med 2002;18(4): 853–866.PubMedGoogle Scholar
  64. 64.
    Tucker HN, Miguel SG. Cost containment through nutrition intervention. Nutr Rev 1996;54:111–121.PubMedGoogle Scholar
  65. 65.
    Sanders DS, Carter, MJ, D’Silva J, James G, Bolton RP, Bardham KD, Survival analysis in percutaneous endoscopic gastrostomy feeding: A worse outcome in patients with dementia. Am J Gastroent 2000;95:1472–1475.PubMedGoogle Scholar
  66. 66.
    Mitchell SL, Kiely DK, Lipsitz LA. The risk factors and impact on survival of feeding tube placement in nursing home residents with severe cognitive impairment. Arch Int Med 1997;157:327–332.Google Scholar
  67. 67.
    Hebuterne X., Broussard JF, Rampal P. Acute renutrition by cyclic enteral nutrition in elderly and younger patients. JAMA 1995;273: 638–643.PubMedGoogle Scholar
  68. 68.
    Henderson CT, Trumbore LS, Mobarhan S, Benya R, Miles TP. Prolonged tube feeding in long-term care: Nutritional status and clinical outcomes. J Am Coll Nutrition 1992;11:309–325.Google Scholar
  69. 69.
    Mortelmans AK, Vanholder R. Intradialytic parenteral nutrition in malnourished hemodialysis patients: Review of the literature. Miner Electrolyte Metab 1999;25:324–332.PubMedGoogle Scholar
  70. 70.
    Fiaccadori E, Lomardi M, Leonardi S, Rotelli CF, Tortorella G, Borghetti A. Prevalence and clinical outcome associated with preexisting malnutrition in acute renal failure: A prospective cohort study. J Am Soc Nephrol 1999;10:581–593.PubMedGoogle Scholar
  71. 71.
    Oksa H, Ahonen K, Pasternack A, Marnela KM. Malnutrition in hemodialysis patients. Scand J Urol Nephrol 1991;25:157–161.PubMedGoogle Scholar
  72. 72.
    Glodwasser P, Mittman M, Antignani A, Burrel D, Michel M, Collier T, Avram MM. Predictors of mortality on hemodialysis. J Am Soc Nephrol 1993;3:1613–1622.Google Scholar
  73. 73.
    Kopple JD. Dietary protein and energy requirements in ESRD patients. Am J Kidney Disease 1998;32(supp):S97–104.Google Scholar
  74. 74.
    Acchiardo SR, Moore LW, Latour PA. Malnutrition as the main factor in morbidity and mortality of hemodialysis patient. Kidney Int 1983;24(supp): S199–203.Google Scholar
  75. 75.
    Marckman P. Nutritional status and mortality of patients in regular dialysis therapy. J Int Med 1989;226:429–432.Google Scholar
  76. 76.
    Ikizler TA, Wingard RL, Harvell J, Shyr Y, Hakim R. Association of morbidity with markers of nutrition and inflammation in chronic hemodialysis patients: A prospective study. Kidney Int 1999;55:1945–1951.PubMedGoogle Scholar
  77. 77.
    Combe C, McCullough KP, Asano Y, Ginsberg N, Maroni BJ, Pifer TB. Kidney disease outcomes quality initiative (K/DOQI) and the dialysis outcomes and practice patterns study (DOPPS): Nutrition guidelines, indicators, and practices. Am J Kidney Dis 2004;44(supp):S39–S46.Google Scholar
  78. 78.
    Stenvinkel P, Heimburger O, Paultre F, Diezfalusy U, Wang T, Bergland L, Jogestrand T. Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure. Kidney Int 1999;55:1899–1911.PubMedGoogle Scholar
  79. 79.
    Kalantar-Zadeh K, Kopple JD. Relative contributions of nutrition and inflammation to clinical outcome in dialysis patients. Am J Kidney Dis 2001;38: 1343–1350.PubMedGoogle Scholar
  80. 80.
    Kalantar-Zadeh K, Kopple JD, Humphreys MH, Block G. Comparing outcome predictability of markers of malnutrition-inflammation complex syndrome in haemodialysis patients. Neph Dial Transplant 2004;19:2926–2927.Google Scholar
  81. 81.
    Kalantar-Zadeh K, Block G, McAllister CJ, Humphreys MH, Kopple JD. Appetite and inflammation, nutrition, anemia, and clinical outcome in hemodialysis patients. Am J Clin Nutr 2004;80(2):299–307.PubMedGoogle Scholar
  82. 82.
    Kopple JD. Pathophysiology of protein-energy wasting in chronic renal failure. J Nutr 1999;129(supp):247S–251S.PubMedGoogle Scholar
  83. 83.
    Ikizler TA, Greene JH, Wingard RL, Parker RA, Hakim RM. Spontaneous dietary intake during progression of chronic renal failure. J Am Soc Nephrol 1995;6:1386–1391.PubMedGoogle Scholar
  84. 84.
    Kopple JD. Nutrition diet and the kidney. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ (eds) Modern nutrition in health and disease. 10th edn. Philadelphia: Lippincott Williams & Wilkins, 2006: 1475–1511.Google Scholar
  85. 85.
    Bossola M, Muscaritoli M, Tazza L, Giungi S, Tortorelli A, Fanelli FR, Luciani G. Malnutrition in hemodialysis patients: what therapy? Am J Kidney Dis 2005;46(3):371–386.PubMedGoogle Scholar
  86. 86.
    Wang H, Casaburi R, Taylor WE, Aboellail H, Storer TW, Kopple JD. Skeletal muscle mRNA for IGF-IEa, IGF-II, and IGF-I receptor is decreased in sedentary chronic hemodialysis patients. Kidney Int. 2005;68:352–361.PubMedGoogle Scholar
  87. 87.
    Capelli JP. Effect of intradialytic parenteral nutrition on mortality rates in end-stage renal disease care. Am J Kidney Dis 1994 Jun;23(6):808–816.PubMedGoogle Scholar
  88. 88.
    Chertow GM, Ling J, Lew NL, Lazarus JM, Lowrie EG. The association of intradialytic parenteral nutrition administration with survival in hemodialysis patients. Am J Kidney Dis 1994;24:912–920.PubMedGoogle Scholar
  89. 89.
    Cherry N, Shalansky K. Efficacy of intradialytic parenteral nutrition in malnourished hemodialysis patients. Am J Health Sys Pharm 2002;59:1736–1741.Google Scholar
  90. 90.
    Openbrier DR, Irwin MM, Rogers RM, Gottlieb GP, Dauber JH, Van Thiel DH, Pennock BE. Nutritional status and lung function in patients with emphysema and chronic bronchitis. Chest 1983;83(1):17–22.PubMedGoogle Scholar
  91. 91.
    Pape GS, Friedman M, Underwood LE, Clemmons DR. The effect of growth hormone on weight gain and pulmonary function in patients with chronic obstructive lung disease. Chest 1991;99(6):1495–1500.PubMedGoogle Scholar
  92. 92.
    Vandenbergh E, van de Woestijne KP, Gyselen A. Weight changes in the terminal stages of chronic obstructive pulmonary disease. Am Rev Resp Dis 1967;95: 556–566.PubMedGoogle Scholar
  93. 93.
    Gray-Donald K, Gibbons L, Shapiro SH, Macklem PT, Martin JG. Nutritional status and mortality in chronic obstructive pulmonary disease. Am J Respiratory Critical Care Med 1996;153:961–966.Google Scholar
  94. 94.
    Schols AM, Slangen J, Volovics L, Wouters EF. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am Rev Respiratory Disease 1998;157:1791–1798.Google Scholar
  95. 95.
    Wilson DO, Rogers RM, Wright EC, Anthonisen NR. Body weight in chronic obstructive pulmonary disease. The National Institutes of Health Intermittent Positive-Pressure Breathing Trial. Am Rev Respir Dis 1989;139:1435–1438.PubMedGoogle Scholar
  96. 96.
    Landbo C. Prescott E, Lange P, Vestbo J, Almdal TP. Prognostic value of nutritional status in chronic obstructive pulmonary disease. Am J Resp Crit Care Med 1999;160:1856–1861.PubMedGoogle Scholar
  97. 97.
    Chailleux E, Laaban JP, Veale D. Prognostic value of nutritional depletion in patients with COPD treated by long-term oxygen therapy: data from the ANTADIR observatory. Chest 2003;123(5):1460–1466.PubMedGoogle Scholar
  98. 98.
    Wilson DO, Donahoe M, Rogers RM, Pennock BE. Metabolic rate and weight loss in chronic obstructive lung disease. JPEN 1990;14:7–11.Google Scholar
  99. 99.
    Lewis MI. Sieck GC. Fournier M. Belman MJ. Effect of nutritional deprivation on diaphragm contractility and muscle fiber size. J Appl Phys 1986;60:596–603.Google Scholar
  100. 100.
    Kelly SM, Rosa A, Field S, Coughlin M, Shizgal HM, Macklem PT. Inspiratory muscle strength and body composition in patients receiving total parenteral nutrition therapy. Am Rev Respir Dis 1984;130:33–37.PubMedGoogle Scholar
  101. 101.
    Askanazi J, Weissman C, La Sala PA, Milic-Emili J, Kinney JM. Effect of protein intake on ventilatory drive. Anesthesiology 1984;60:106–110.PubMedGoogle Scholar
  102. 102.
    Pingleton SK, Harmon GS. Nutritional management in acute respiratory failure. JAMA 1987;257:3094–3099.PubMedGoogle Scholar
  103. 103.
    Mallampalli, A. Nutritional management of the patient with chronic obstructive lung disease. Nutr Clin Pract 2004;19(6):550–556.PubMedGoogle Scholar
  104. 104.
    Fuenzalida CE, Petty Tl, Jones ML. The immune response to short term nutritional intervention in advanced COPD. Am Rev Respir Dis 1990;142:49–56.PubMedGoogle Scholar
  105. 105.
    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.Google Scholar
  106. 106.
    Burdet L, de Muralt B, Schutz Y, Pichard C, Fitting JW. Administration of growth hormone to underweight patients with chronic obstructive pulmonary disease. A prospective, randomized, controlled study. Am J Respir Crit Care Med. 1997;156(6):1800–1806.PubMedGoogle Scholar
  107. 107.
    Casaburi R, Porszasz J, Burns MR, Carithers ER, Chang RS, Cooper CB. Physiologic benefits of exercise training in rehabilitation of patients with severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1997;155(5):1541–1551.PubMedGoogle Scholar
  108. 108.
    Ferreira IM, Verreschi IT, Nery LE, Goldstein RS, Zamel N, Brooks D, Jardim JR. The influence of 6 months of oral anabolic steroids on body mass and respiratory muscles in undernourished COPD patients. Chest 1998;114:19–28.PubMedGoogle Scholar
  109. 109.
    Kwan R, Mir MA. Beneficial effects of dietary carbohydrate restriction in chronic cor pulmonale. Am J Med 1987;82(4):751–758.PubMedGoogle Scholar
  110. 110.
    Cai B, Zhu Y, Ma Y, Xu Z, Zao Y, Wang J, Lin Y, Comer GM. Effect of supplementing a high-fat, low-carbohydrate enteral formula in COPD patients. Nutrition 2003;19(3):229–232.PubMedGoogle Scholar
  111. 111.
    Angelillo VA, Bedi S, Durfee D, Dahl J, Patterson AJ, O’Donohue WJ Jr. Effects of low and high carbohydrate feedings in ambulatory patients with chronic obstructive pulmonary disease and chronic hypercapnia. Ann Intern Med 1985;103:883–835.PubMedGoogle Scholar
  112. 112.
    Efthimiou J, Mounsey PJ, Benson DN, Madgwick R, Coles SJ, Benson MK. Effect of carbohydrate rich versus fat rich loads on gas exchange and walking performance in patients with chronic obstructive lung disease. Thorax. 1992;47:451–456.PubMedGoogle Scholar
  113. 113.
    Detsky AS, Baker JP, O’Rourke K, et al. Predicting nutrition-associated complications for patients undergoing gastrointestinal surgery. JPEN 1987;11:440–446.Google Scholar
  114. Perioperative total parenteral nutrition in surgical patients. The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. NEJM. 1991;325(8): 525–532.Google Scholar
  115. 115.
    Muller JM, Brenner U, Dienst C, Pichlmaier H. Preoperative parenteral feeding in patients with gastrointestinal carcinoma. Lancet 1982;1:68–71.PubMedGoogle Scholar
  116. 116.
    Bozzetti F, Gavazzi C, Miceli R, Rossi N, Mariani L, Cozzaglio L, Bonfanti G, Piacenza S. Perioperative total parenteral nutrition in malnourished, gastrointestinal cancer patients: a randomized, clinical trial. JPEN 2000;24(1):7–14.Google Scholar
  117. 117.
    Heyland DK, Montalvo M, MacDonald S, Keefe L, Su XY, Drover JW. Total parenteral nutrition in the surgical patient: a meta-analysis. Can J Surg. 2001;44(2):102–111.PubMedGoogle Scholar
  118. 118.
    Woolfson AMJ, Smith JAR. Elective nutritional support after elective surgery: aprospective randomized trial. Clin Nutr 1989;8:15–21.PubMedGoogle Scholar
  119. 119.
    Heslin MJ, Latkany L, Leung D, Brooks AD, Hochwald SN, Pisters PW, Shike M, Brennan MF. A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy. Ann Surg. 1997;226:567–577.PubMedGoogle Scholar
  120. 120.
    Koretz, RL. Is longer better? Gastroenterology 2006;130(1):277–278.PubMedGoogle Scholar
  121. 121.
    Gianotti L, Braga M, Nespoli L, Radaelli G, Beneduce A, Di Carlo V. A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer. Gastroenterology 2002;122(7):1763–1770.PubMedGoogle Scholar
  122. 122.
    Pikul J, Sharpe MD, Lowndes R, Guent C. Degree of preoperative malnutrition is predictive of postoperative morbidity and mortality in liver transplant recipients. Transplantation 1994;57:469.PubMedGoogle Scholar
  123. 123.
    Harrison J, McKiernan J, Neuberger JM. A prospective study on the effect of recipient nutritional status on outcome in liver transplantation. Transpl Int. 1997;10(5):369–374.PubMedGoogle Scholar
  124. 124.
    Hasse JM. Nutrition assessment and support of organ transplant recipients. JPEN 2001;25(3): 120–131.Google Scholar
  125. 125.
    Madill J, Gutierrez C, Grossman J et al. Nutritional assessment of the lung transplant patient: body mass index as a predictor of 90-day mortality following transplantation. J Heart Lung Transplant 2001;20:288–296.PubMedGoogle Scholar
  126. 126.
    Becker BN, Becker YT, Heisey DM, Leverson GE, Collins BH, Odorico JS, D’Alessandro AM, Knechtle SJ, Pirsch JD, Sollinger HW. The impact of hypoalbuminemia in kidney-pancreas transplant recipients. Transplantation 1999;68(1):72–75.PubMedGoogle Scholar
  127. 127.
    Schwebel C, Pin I, Barnoud D, Devouassoux G, Brichon PY, Chaffanjon P, Chavanon O, Sessa C, Blin D, Guignier M, Leverve X, Pison C. Prevalence and consequences of nutritional depletion in lung transplant candidates. Eur Respir J 2000;16:1050–1055.PubMedGoogle Scholar
  128. 128.
    Singer LG, Brazelton TR, Doyle RL, et al. Weight gain after lung transplantation. J Heart Lung Transplant 2003; 22:894–902.PubMedGoogle Scholar
  129. 129.
    Kyle UG, Nicod L, Romand JA et al. Four-year follow-up of body composition in lung transplant patients. Transplantation 2003;75:821–828.PubMedGoogle Scholar
  130. 130.
    Hasse JM, Crippin JS, Blue LS, et al. Does nutrition supplementation benefit liver transplant candidates with a history of hepatic encephalopathy?[abstract] JPEN 1997;21:S16.Google Scholar
  131. 131.
    Hade AM, Shine AM, Kennedy NP, McCormick PA. Both under-nutrition and obesity increase morbidity following liver transplantation. Ir Med J 2003;96(5):140–142.PubMedGoogle Scholar

Copyright information

© Humana Press Inc 2008

Authors and Affiliations

  • W. Scott Butsch
  • Douglas C. Heimburger

There are no affiliations available

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