Weight Gain After Lung Volume Reduction Surgery Is Not Correlated With Improvement in Pulmonary Mechanics: Discussion

26 Sep
2014

Weight Gain After Lung Volume Reduction Surgery Is Not Correlated With Improvement in Pulmonary Mechanics: DiscussionThis study demonstrates that there are substantial increases in body weight during the first year after LVRS. The gain in weight was found to be more prominent in women than in men, and it tended to occur in patients who were leaner prior to surgery. The increased body weight did not correlate with improvement in lung mechanics or decrease in lung volumes, but did correlate with improvement in gas exchange as measured by diffusing capacity. This data may provide insights into the mechanism of weight loss in patients with emphysema. canadian pharmacy

Weight loss and malnutrition are common in patients with COPD. Nutritional surveys of COPD patients have found evidence of malnutrition in a high percentage of patients. Weight loss is also seen as the disease progresses. These patients tend to have high health-care utilization. There are functional correlations between low body weight and both exercise performance and respiratory muscle weakness. In addition, low body weight is correlated with poor quality of life, although these effects are mediated by respiratory symptoms, primarily dyspnea. Low body weight also is an independent predictor of mortality in patients with COPD. Thus, malnutrition is a significant problem in patients with COPD and leads to significant morbidity and mortality.
The exact mechanism of weight loss in patients with emphysema is not known. It has been known for some time that there is increased resting energy expenditure in malnourished patients with COPD and that this increase is due at least in part to an increased oxygen cost of breathing. This likely is related to inefficiencies in respiratory muscle function as a result of hyperinflation. Many other factors probably play a role in the weight loss seen in COPD patients, including chronic inflammation from bronchial infection; loss of muscle mass and strength associated with aging and inactivity; and medications, particularly corticosteroids, that are often used to treat COPD and lead to muscle wasting. Thus, the mechanism of weight loss in patients with COPD is complex.

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