Weight gain after lung volume reduction surgery is not correlated with improvement in pulmonary mechanics

被引:14
作者
Christensen, PJ
Paine, R
Curtis, JL
Kazerooni, EA
Iannettoni, MD
Martinez, FJ
机构
[1] Vet Affairs Med Ctr, Ann Arbor, MI 48105 USA
[2] Univ Michigan, Div Pulm & Crit Care Med, Ann Arbor, MI 48109 USA
[3] Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA
[4] Univ Michigan, Dept Radiol, Ann Arbor, MI 48109 USA
[5] Univ Michigan, Dept Surg, Ann Arbor, MI 48109 USA
关键词
body weight; emphysema; lung function; nutrition; obstructive lung disease; surgery;
D O I
10.1378/chest.116.6.1601
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Study objectives: Malnutrition and low body weight are common in patients with emphysema, Previous work has demonstrated correlation between severity of airflow obstruction and body weight. Lung volume reduction surgery (LVRS) is a recent advance in the treatment of patients with severe emyhysema that results in improved pulmonary: function. We formed the hypothesis that improved lung mechanics after LVRS would result in body weight gain. Design: Retrospective chart review, Patients: All patients who underwent bilateral LVRS for severe emphysema at the University: of Michigan between January 1995 and April 1996 were eligible for the study. Measurements and results: Pulmonary function and bod! weight were measured preoperatively and at 3, 6, and 12 months postoperatively for patients who underwent bilateral LVRS between January 1995 and April 1996, The average weight gain in 38 patients returning for 12 months of follow-up was 3.8 +/- 0.9 kg, or 6.2% of the preoperative weight. Women gained significantly more weight than men (9.2 vs 2.2%, respectively) at 1 year. Interestingly, there was no correlation between change in weight and postoperative change in FEV1, FVC, residual volume (RV), total lung capacity (TLC), or RV/TLC at 12 months. However, there was a statistically significant correlation between weight gained and improvement in diffusion of carbon monoxide measured 12 months postoperatively. Conclusions: This study shows that patients with severe emphysema gain weight after LVRS, These changes were independent of changes in pulmonary mechanics but may be a result of improved gas exchange. These findings provide further information about benefits of LVRS in patients with advance emphysema that are beyond simple changes in pulmonary function.
引用
收藏
页码:1601 / 1607
页数:7
相关论文
共 25 条
[1]   DIFFERING EFFECTS OF AIRWAY-OBSTRUCTION ON PHYSICAL WORK CAPACITY AND VENTILATION IN MEN AND WOMEN WITH COPD [J].
CARTER, R ;
NICOTRA, B ;
HUBER, G .
CHEST, 1994, 106 (06) :1730-1739
[3]   BILATERAL PNEUMECTOMY (VOLUME REDUCTION) FOR CHRONIC OBSTRUCTIVE PULMONARY-DISEASE [J].
COOPER, JD ;
TRULOCK, EP ;
TRIANTAFILLOU, AN ;
PATTERSON, GA ;
POHL, MS ;
DELONEY, PA ;
SUNDARESAN, RS ;
ROPER, CL .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1995, 109 (01) :106-119
[4]   Results of 150 consecutive bilateral lung volume reduction procedures in patients with severe emphysema [J].
Cooper, JD ;
Patterson, GA ;
Sundaresan, RS ;
Trulock, EP ;
Yusen, RD ;
Pohl, MS ;
Lefrak, SS .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1996, 112 (05) :1319-1329
[5]  
DONAHOE M, 1992, RESPIRATION, V59, P33
[6]   OXYGEN-CONSUMPTION OF THE RESPIRATORY MUSCLES IN NORMAL AND IN MALNOURISHED PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY-DISEASE [J].
DONAHOE, M ;
ROGERS, RM ;
WILSON, DO ;
PENNOCK, BE .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1989, 140 (02) :385-391
[7]   Nutritional support in advanced lung disease - The pulmonary cachexia syndrome [J].
Donahoe, M .
CLINICS IN CHEST MEDICINE, 1997, 18 (03) :547-+
[8]   CHRONIC OBSTRUCTIVE BRONCHOPULMONARY DISEASE .2. OXYGEN TRANSPORT IN 2 CLINICAL TYPES [J].
FILLEY, GF ;
BECKWITT, HJ ;
REEVES, JT ;
MITCHELL, RS .
AMERICAN JOURNAL OF MEDICINE, 1968, 44 (01) :26-&
[9]   MUSCLE METABOLISM IN PATIENTS WITH CHRONIC OBSTRUCTIVE LUNG-DISEASE AND ACUTE RESPIRATORY-FAILURE [J].
GERTZ, I ;
HEDENSTIERNA, G ;
HELLERS, G ;
WAHREN, J .
CLINICAL SCIENCE AND MOLECULAR MEDICINE, 1977, 52 (04) :395-403
[10]  
GOLDMAN HI, 1959, AM REV TUBERC PULM, V79, P457