Evaluation of nutritional status and nutritional therapy in chronic obstructive pulmonary disease

Редакционная, статья

doi:10.18093/0869-0189-2016-26-1-13-28

Cited by 3 publications

(1 citation statement)

References 127 publications

(113 reference statements)

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“…Это обусловило его минимальный вклад в прогноз развития БКВС на этапе включения в исследование при выведении пациентов с легким и среднетяжелым течением ХОБЛ и потерю статистической достоверности при включении в регрессию суммы баллов по шкале PROCAM. Биоимпедансное исследование согласно ряду работ наиболее показательно для оценки нутритивного статуса больных ХОБЛ, но является труднодоступным в ежедневной практике [28]. Оценка нарушений питания рутинными методами не может служить инструментом оценки риска развития для больных с тяжелым и крайне тяжелым течением ХОБЛ в сочетании с ХБП 1-2-й стадий.…”

Section: материалы и методыunclassified

Predictors for development of major cardiovascular events in elderly patients with severe and extremely severe chronic obstructive pulmonary disease in combination with early stages of chronic kidney disease

2019

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Aim. To study the structure of major cardiovascular events (MCVE) and to identify their independent predictors in elderly patients with severe and extremely severe chronic obstructive pulmonary disease (COPD) in combination with early stages of chronic kidney disease (CKD). Materials and methods. The study included 172 elderly patients with stage 3–4 COPD associated with stage 1–2 CKD. Initially, risk factors for MCVE were identified and levels of vitamin D (25 (ОН) D) were measured for all patients. In 12 months, MCVE anamnesis was collected, and patients were divided into two groups with and without MCVE during the observation period. The risk factors for MCVE, which were significantly different between the two groups according to results of a one-way analysis, were successively included into a logistic regression for identifying independent predictors of MCVE. A ROC analysis was performed for the identified variables to identify a predictive cut-off point. Results. 21 MCVEs were observed in 8.7% (15) patients. Heart rhythm disorders (HRD) not reversed at the prehospital stage were observed in 38.1% patients; acute cerebrovascular disease and transient ischemic attack – in 23.8%, acute coronary syndrome – in 23.8%, and pulmonary thromboembolism (PTE) – in 14.3%. Two MCVEs, namely, a combination of HRD not reversed at the prehospital stage and PTE, were observed in 3 (20%) patients. The ROC analysis showed that the incidence of COPD exacerbation for the previous 12 months >3 had the highest predictive value for the 12-month risk of MCVE in patients with COPD associated with early CKD (95% CI, 0.823–0.925, р=0.001). A total PROCAM score <50 (95% CI, 0.882–0.964, р=0.001); GFR ≥80 ml/min/1.73 m2 (95% CI, 0.750–0.870, р=0.001); and a level of vitamin D ≥33 ng/ml (95% CI, 0.730–0.855, р=0.001) reduced the risk for MCVE. Conclusions. In elderly patients with grade 3–4 COPD associated with stage 1–2 CKD, the development of MCVE within 12 months was determined by the incidence of COPD exacerbations for the previous 12 months >3 while a total PROCAM score <50, GFR >80 ml/min/1.73 m3 , and levels of vitamin D >33 ng/ml reduced the risk of MCVE in these patients

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Section: материалы и методыunclassified

Predictors for development of major cardiovascular events in elderly patients with severe and extremely severe chronic obstructive pulmonary disease in combination with early stages of chronic kidney disease

2019

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Respiratory muscle dysfunction and chronic obstructive pulmonary disease.

2018

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The review presents literature data on the problem of respiratory muscle (RM) dysfunction in patients with chronic obstructive pulmonary disease (COPD). In the development of RM dysfunction, both local and systemic factors of the pathogenesis of COPD are important. Local factors are associated with lung remodelling and the need to overcome RM excessive breathing resistance, which increases the intensity of their work, contributes to the development of hypertrophy and insufficiency. Chronic systemic inflammation, oxidative stress, excessive proteolysis and other systemic manifestations of COPD change the metabolism and structural and functional organisation of RM. Low nutritional status, increasing protein-energy deficiency, electrolyte imbalance, endocrine disorders against the background of progressive respiratory insufficiency and tissue hypoxia contribute to the development of RM weakness. The combination of COPD, acute disorders of cerebral circulation and chronic heart failure sharply worsens the function of RM and the prognosis of comorbid diseases. Also, the dysfunction of RM in patients with COPD is significantly aggravated at the age of senility. The review discusses the possibilities of pharmacological correction of RM dysfunction and other clinical aspects of this problem.

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Respiratory and muscular dysfunction of the respiratory muscles and chronic obstructive pulmonary disease: pathophysiological relationships and clinical significance

Гельцер

Kotelnikov

Кожанов

2022

Tihookeanskij medicinskij žurnal

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The review presents literature data on the problem of respiratory muscle (RM) dysfunction in patients with chronic obstructive pulmonary disease (COPD). The main features of their pathophysiological interactions and clinical practice values were observed. Both local and systemic factors of the pathogenesis of COPD are important in the development of RM dysfunction. Local factors are associated with lung remodeling and the need of RM to overcome excessive breathing resistance, which increases the intensity of their work, and contributes to the development of hypertrophy and insufficiency. Chronic systemic inflammation, oxidative stress, excessive proteolysis and other systemic manifestations of COPD change the metabolism, structural and functional organization of RM. The severity of morpho-functional disorders and metabolic status of RM depends on the gravity of COPD and emerges on the early stages as myocytes’ hypertrophy, their increasing capillarization and the increasing of mitochondrion density. At late stages it appears as diffuse replacement of muscle fibers by connective tissue. Low nutritional status, increasing protein-energy deficiency, electrolyte imbalance, endocrine disorders on the background of progressive respiratory insufficiency and tissue hypoxia contribute to the development of RM weakness. The combination of COPD, acute disorders of cerebral circulation and chronic heart failure sharply worsens the function of RM and the prognosis of comorbid diseases. Also, the dysfunction of RM in patients having COPD is significantly aggravated at the age of senility. The review discusses the possibilities of pharmacological correction of RM dysfunction and other clinical aspects of this problem.

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Evaluation of nutritional status and nutritional therapy in chronic obstructive pulmonary disease

Cited by 3 publications

References 127 publications

Predictors for development of major cardiovascular events in elderly patients with severe and extremely severe chronic obstructive pulmonary disease in combination with early stages of chronic kidney disease

Predictors for development of major cardiovascular events in elderly patients with severe and extremely severe chronic obstructive pulmonary disease in combination with early stages of chronic kidney disease

Respiratory muscle dysfunction and chronic obstructive pulmonary disease.

Respiratory and muscular dysfunction of the respiratory muscles and chronic obstructive pulmonary disease: pathophysiological relationships and clinical significance

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