BACKGROUND: The impact of reduction pneumoplasty on body weight and nutritional status has not previously been tested in a controlled study. METHODS: We investigated 60 patients with severe emphysema who were randomly assigned to receive either reduction pneumoplasty (n = 30) or a 6-week respiratory rehabilitation program (n = 30). Nutritional status was evaluated by means of body mass index, triceps skin fold measurement, midarm muscle circumference, and biochemical blood values. Fat mass and fat-free mass were calculated by bioelectric impedance. Two treatment-related deaths occurred after reduction pneumoplasty and 1 death occurred after respiratory rehabilitation. RESULTS: Functional and subjective improvements were significantly showed in reduction pneumoplasty group. Despite insignificant differences in energy intake, the reduction pneumoplasty group showed significant gain (P <.0001) relative to the respiratory rehabilitation group in mean weight changes at 3 months (1.82 +/- 2.63 kg vs -0.57 +/- 2.25 kg), 6 months (2.87 +/- 3.79 kg vs -1.11 +/- 2.64 kg), and 12 months (3.29 +/- 4.01 kg vs -0.95 +/- 1.90 kg). Both fat mass and fat-free mass increased after surgery, but only fat-free mass had a significant improvement (P =.001). Six-month weight gain in the reduction pneumoplasty group was significantly correlated with low baseline weight (rho = -0.437, P =.02) and residual volume reduction (rho = -0.446, P =.01). Total proteins (P =.003), albumin (P =.03), transferrin (P =.04), cholesterol (P =.003), hemoglobin (P =.01), triceps skin fold measurement (P <.0001), and midarm muscle circumference (P <.0001) were significantly increased only in the reduction pneumoplasty group. Conversely, in the respiratory rehabilitation group no nutritional index was significantly increased at 6 months after rehabilitation. CONCLUSIONS: Body weight and nutritional status improved only after reduction pneumoplasty and not after respiratory rehabilitation, and this was significantly related to fat-free mass increment. In the reduction pneumoplasty group, the residual volume result was significantly correlated with postoperative weight gain.

Mineo, T.c., Ambrogi, V., Pompeo, E., Bollero, P., Mineo, D., Nofroni, I. (2002). Body weight and nutritional changes after reduction pneumoplasty for severe emphysema: a randomized study. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 124(4), 660-667 [10.1067/mtc.2002.123807].

Body weight and nutritional changes after reduction pneumoplasty for severe emphysema: a randomized study

MINEO, TOMMASO CLAUDIO;AMBROGI, VINCENZO;POMPEO, EUGENIO;BOLLERO, PATRIZIO;MINEO, DAVIDE;
2002-10-01

Abstract

BACKGROUND: The impact of reduction pneumoplasty on body weight and nutritional status has not previously been tested in a controlled study. METHODS: We investigated 60 patients with severe emphysema who were randomly assigned to receive either reduction pneumoplasty (n = 30) or a 6-week respiratory rehabilitation program (n = 30). Nutritional status was evaluated by means of body mass index, triceps skin fold measurement, midarm muscle circumference, and biochemical blood values. Fat mass and fat-free mass were calculated by bioelectric impedance. Two treatment-related deaths occurred after reduction pneumoplasty and 1 death occurred after respiratory rehabilitation. RESULTS: Functional and subjective improvements were significantly showed in reduction pneumoplasty group. Despite insignificant differences in energy intake, the reduction pneumoplasty group showed significant gain (P <.0001) relative to the respiratory rehabilitation group in mean weight changes at 3 months (1.82 +/- 2.63 kg vs -0.57 +/- 2.25 kg), 6 months (2.87 +/- 3.79 kg vs -1.11 +/- 2.64 kg), and 12 months (3.29 +/- 4.01 kg vs -0.95 +/- 1.90 kg). Both fat mass and fat-free mass increased after surgery, but only fat-free mass had a significant improvement (P =.001). Six-month weight gain in the reduction pneumoplasty group was significantly correlated with low baseline weight (rho = -0.437, P =.02) and residual volume reduction (rho = -0.446, P =.01). Total proteins (P =.003), albumin (P =.03), transferrin (P =.04), cholesterol (P =.003), hemoglobin (P =.01), triceps skin fold measurement (P <.0001), and midarm muscle circumference (P <.0001) were significantly increased only in the reduction pneumoplasty group. Conversely, in the respiratory rehabilitation group no nutritional index was significantly increased at 6 months after rehabilitation. CONCLUSIONS: Body weight and nutritional status improved only after reduction pneumoplasty and not after respiratory rehabilitation, and this was significantly related to fat-free mass increment. In the reduction pneumoplasty group, the residual volume result was significantly correlated with postoperative weight gain.
ott-2002
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/21 - CHIRURGIA TORACICA
English
Con Impact Factor ISI
Nutritional Status; Emphysema; Nutrition Assessment; Humans; Algorithms; Energy Intake; Body Mass Index; Forced Expiratory Volume; Body Weight; Pneumonectomy; Prospective Studies; Treatment Outcome; Nutrition Disorders
Mineo, T.c., Ambrogi, V., Pompeo, E., Bollero, P., Mineo, D., Nofroni, I. (2002). Body weight and nutritional changes after reduction pneumoplasty for severe emphysema: a randomized study. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 124(4), 660-667 [10.1067/mtc.2002.123807].
Mineo, Tc; Ambrogi, V; Pompeo, E; Bollero, P; Mineo, D; Nofroni, I
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/64795
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