PATIENTS WITH CHRONIC AIR-FLOW OBSTRUCTIO N RECEIVING DOMICILIARY OXYGEN-THERAPY - A STUDY OF CLINICAL-PARAMETERS, NUTRITIONAL-STATUS AND MOBILITY

Aim of the study. The aim of the study was to document the nutritional status and the calorie demands of patients suffering from severe chro nic airflow obstruction (BPCO) who were on continuous domiciliary oxyg en therapy (OCD) and to correlate this information with the clinical p icture, the severity of the respiratory disease and the daily distance walked, this to be measured in a prospective manner. Patients and met hods. Fifty clinically stable patients with chronic airflow obstructio n on continuous oxygen therapy for 33 months (range 4-106) in whom the following measures were made at home: pulmonary function, maximal sta tic inspiratory and expiratory pressure (PIMAX and PEMAX), strength of hand grip, the mean distance walked daily (wearing a pedometer for on e week), body mass index (IMC), and the body composition by electrical bio-impedence and calorie requirements. Results. Thirty Sour pet. cen t of patients presented with an excessive body mass (IMC >27 kg/m(2)), 42 per cent had normal nutrition (IMC 20-27 kg/m(2)) and 24 per cent were malnourished (IMC <20 kg/m(2)). Malnourished patients had, in a s tatistically significant manner, airflow obstruction of greater severi ty and a lower oxygen saturation and a PEMAX as well as a lower daily distance compared to over weight subjects. However; their net calorie requirements were markedly higher (39+/-5 Kcal/kg/j) compared to patie nts having normal weight (29+/-11 kcal/kg/j) or excess weight (25+/-8 kcal/kg/j). From the clinical standpoint no malnourished patient fulfi lled the clinical criteria of chronic bronchitis. By contrast 61 per c ent of subjects with normal nutrition and 94 per cent of subjects with excessive weighs were chronic bronchitics. Conclusion. In the group o f patients with severe airflow obstruction on domiciliary oxygen, 25 p er cent were malnourished and this was in spite of netly increased cal orie consumption which is superior to their theoretical need. This sug gests that the solution of increasing supplements to their dietary req uirements would be a difficult to realise. These subjects presented al so with a more marked ventilatory handicap and a clinical picture char acterised by the absence of the classical signs of chronic bronchitis.