ALTERATION IN NUTRITIONAL-STATUS AND DIAPHRAGM MUSCLE FUNCTION

Diet-induced undernutrition causes deleterious changes in the structur e and function of the diaphragm muscle. Diseases associated with somat ic washing cause atrophy of the respiratory muscles. In cachectic subj ects, the diaphragm muscle mass and thickness an reduced in proportion to the reduction in body weight. In addition, respiratory muscle stre ngth and endurance are reduced more dramatically than the weight loss. This finding suggests that malnutrition induces a reduction in muscul ar mass which is associated with a decrease in contractility. Diaphrag matic weakness may increase the risk of respiratory failure in patient s with chronic obstructive pulmonary disease (COPD). The primary goal of a successful nutritional programme is to improve the diaphragm stre ngth by correcting the mineral, electrolyte and energetic disturbances at the muscular level, the latter being responsible for the decreased contractability associated with malnutrition. (C) Inra/Elsevier, Pari s.