Nutrition and chronic respiratory failure.

Protein calorie malnutrition is frequently observed in patients with chroni c obstructive pulmonary disease (COPD). The main mechanism is hypermetaboli sm essentially resulting from increased oxygen consumption of the respirato ry muscles. Malnutrition is associated with poor prognosis, irrespective of age and respiratory function impairment. Malnutrition has several harmful consequences on the respiratory system: atrophy and decreased strength of t he respiratory muscles. decreased exercise performance, decreased quality o f life, and likely increased risk of community-acquired and nosocomial pneu monia. A long-duration oral supplementation mag improve the nutritional sta tus and exercise tolerance in ambulatory COPD patients. The interest of ana bolic drugs, especially recombinant growth hormone, has not been demonstrat ed in malnourished COPD patients.