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Nutritional assessment of patients with chronic obstructive pulmonary disease and acute respiratory failure.

In order to determine the likelihood of pre-existing nutritional deficits in medical patients with acute respiratory failure, a nutritional assessment survey was performed on 18 control patients with stable COPD and nine patients with COPD and acute respiratory failure. Significant differences were noted with the respiratory failure group having deficits in percentage of ideal body weight (mean difference 19 percent), triceps skinfold thickness (mean difference 4.4 mm), and arm muscle circumference (mean difference 3.3 cm). Significant deficits were also found in measurements of serum transferrin and retinol binding proteins, creatinine height index and total lymphocyte counts. Body protein and fat stores were markedly depleted in almost half of the patients with respiratory failure. These data suggest that protein-calorie malnutrition is likely to be present in patients with COPD and acute respiratory failure. Nutritional support for this population should be initiated at the onset of the illness. Nutritional repletion should be considered one goal of such therapy.