Nitrogen and energy relationships in malnourished patients with emphysema

S. A. Goldstein, B. M. Thomashow, Vladimir Kvetan, J. Askanazi, J. M. Kinney, D. H. Elwyn

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

The purpose of this study was to examine the impact of nutritional support on nitrogen-energy relationships and functional parameters in malnourished patients with emphysema. Malnourished patients without lung disease served as the control group. Ten ambulatory, stable patients with emphysema and six patients without lung disease received an infusion of 5% dextrose (baseline) plus electrolytes (D5W) for two days, which was followed by an enteral or a parenteral infusion of either a carbohydrate-based (CB, 53% carbohydrate) or a fat-based diet (FB, 55% fat) for 1 wk each, in a randomized cross-over design. All patients had greater than 10% weight loss. Caloric intake was set at 1.7 times the resting energy expenditure (REE) as measured during the baseline period. The REE of patients with emphysema was 23 and 27% above that of the control group during baseline and refeeding periods, respectively. The increased REE was met primarily by an increased carbohydrate oxidation. During the infusion of D5W, N balance was lower in patients with emphysema, but during repletion N balance was similar in both groups of patients. Two weeks of nutritional support with either a CB or a FB diet increased body weight, N balance, and arm muscle area and improved maximal inspiratory pressure, skeletal muscle strength, and endurance-strength (using quadriceps, hamstring, and handgrip) to a similar degree in malnourished patients with and without lung disease. In other stress states, such as infection, it has been shown that hypermetabolism, hypercatabolism, and preferential fat oxidation occur concomitantly. Patients with emphysema are unusual because, althouth they are hypermetabolic, they are not hypercatabolic and do not demonstrate preferential fat oxidation.

Original languageEnglish (US)
Pages (from-to)636-644
Number of pages9
JournalAmerican Review of Respiratory Disease
Volume138
Issue number3
StatePublished - 1988

Fingerprint

Emphysema
Nitrogen
Fats
Carbohydrates
Energy Metabolism
Lung Diseases
Nutritional Support
Parenteral Infusions
Diet
Control Groups
Muscle Strength
Energy Intake
Cross-Over Studies
Electrolytes
Small Intestine
Weight Loss
Skeletal Muscle
Body Weight
Glucose
Muscles

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Goldstein, S. A., Thomashow, B. M., Kvetan, V., Askanazi, J., Kinney, J. M., & Elwyn, D. H. (1988). Nitrogen and energy relationships in malnourished patients with emphysema. American Review of Respiratory Disease, 138(3), 636-644.

Nitrogen and energy relationships in malnourished patients with emphysema. / Goldstein, S. A.; Thomashow, B. M.; Kvetan, Vladimir; Askanazi, J.; Kinney, J. M.; Elwyn, D. H.

In: American Review of Respiratory Disease, Vol. 138, No. 3, 1988, p. 636-644.

Research output: Contribution to journalArticle

Goldstein, SA, Thomashow, BM, Kvetan, V, Askanazi, J, Kinney, JM & Elwyn, DH 1988, 'Nitrogen and energy relationships in malnourished patients with emphysema', American Review of Respiratory Disease, vol. 138, no. 3, pp. 636-644.
Goldstein SA, Thomashow BM, Kvetan V, Askanazi J, Kinney JM, Elwyn DH. Nitrogen and energy relationships in malnourished patients with emphysema. American Review of Respiratory Disease. 1988;138(3):636-644.
Goldstein, S. A. ; Thomashow, B. M. ; Kvetan, Vladimir ; Askanazi, J. ; Kinney, J. M. ; Elwyn, D. H. / Nitrogen and energy relationships in malnourished patients with emphysema. In: American Review of Respiratory Disease. 1988 ; Vol. 138, No. 3. pp. 636-644.
@article{ae19b5b30ad64d8887c78129b99f2470,
title = "Nitrogen and energy relationships in malnourished patients with emphysema",
abstract = "The purpose of this study was to examine the impact of nutritional support on nitrogen-energy relationships and functional parameters in malnourished patients with emphysema. Malnourished patients without lung disease served as the control group. Ten ambulatory, stable patients with emphysema and six patients without lung disease received an infusion of 5{\%} dextrose (baseline) plus electrolytes (D5W) for two days, which was followed by an enteral or a parenteral infusion of either a carbohydrate-based (CB, 53{\%} carbohydrate) or a fat-based diet (FB, 55{\%} fat) for 1 wk each, in a randomized cross-over design. All patients had greater than 10{\%} weight loss. Caloric intake was set at 1.7 times the resting energy expenditure (REE) as measured during the baseline period. The REE of patients with emphysema was 23 and 27{\%} above that of the control group during baseline and refeeding periods, respectively. The increased REE was met primarily by an increased carbohydrate oxidation. During the infusion of D5W, N balance was lower in patients with emphysema, but during repletion N balance was similar in both groups of patients. Two weeks of nutritional support with either a CB or a FB diet increased body weight, N balance, and arm muscle area and improved maximal inspiratory pressure, skeletal muscle strength, and endurance-strength (using quadriceps, hamstring, and handgrip) to a similar degree in malnourished patients with and without lung disease. In other stress states, such as infection, it has been shown that hypermetabolism, hypercatabolism, and preferential fat oxidation occur concomitantly. Patients with emphysema are unusual because, althouth they are hypermetabolic, they are not hypercatabolic and do not demonstrate preferential fat oxidation.",
author = "Goldstein, {S. A.} and Thomashow, {B. M.} and Vladimir Kvetan and J. Askanazi and Kinney, {J. M.} and Elwyn, {D. H.}",
year = "1988",
language = "English (US)",
volume = "138",
pages = "636--644",
journal = "American Journal of Respiratory and Critical Care Medicine",
issn = "1073-449X",
publisher = "American Thoracic Society",
number = "3",

}

TY - JOUR

T1 - Nitrogen and energy relationships in malnourished patients with emphysema

AU - Goldstein, S. A.

AU - Thomashow, B. M.

AU - Kvetan, Vladimir

AU - Askanazi, J.

AU - Kinney, J. M.

AU - Elwyn, D. H.

PY - 1988

Y1 - 1988

N2 - The purpose of this study was to examine the impact of nutritional support on nitrogen-energy relationships and functional parameters in malnourished patients with emphysema. Malnourished patients without lung disease served as the control group. Ten ambulatory, stable patients with emphysema and six patients without lung disease received an infusion of 5% dextrose (baseline) plus electrolytes (D5W) for two days, which was followed by an enteral or a parenteral infusion of either a carbohydrate-based (CB, 53% carbohydrate) or a fat-based diet (FB, 55% fat) for 1 wk each, in a randomized cross-over design. All patients had greater than 10% weight loss. Caloric intake was set at 1.7 times the resting energy expenditure (REE) as measured during the baseline period. The REE of patients with emphysema was 23 and 27% above that of the control group during baseline and refeeding periods, respectively. The increased REE was met primarily by an increased carbohydrate oxidation. During the infusion of D5W, N balance was lower in patients with emphysema, but during repletion N balance was similar in both groups of patients. Two weeks of nutritional support with either a CB or a FB diet increased body weight, N balance, and arm muscle area and improved maximal inspiratory pressure, skeletal muscle strength, and endurance-strength (using quadriceps, hamstring, and handgrip) to a similar degree in malnourished patients with and without lung disease. In other stress states, such as infection, it has been shown that hypermetabolism, hypercatabolism, and preferential fat oxidation occur concomitantly. Patients with emphysema are unusual because, althouth they are hypermetabolic, they are not hypercatabolic and do not demonstrate preferential fat oxidation.

AB - The purpose of this study was to examine the impact of nutritional support on nitrogen-energy relationships and functional parameters in malnourished patients with emphysema. Malnourished patients without lung disease served as the control group. Ten ambulatory, stable patients with emphysema and six patients without lung disease received an infusion of 5% dextrose (baseline) plus electrolytes (D5W) for two days, which was followed by an enteral or a parenteral infusion of either a carbohydrate-based (CB, 53% carbohydrate) or a fat-based diet (FB, 55% fat) for 1 wk each, in a randomized cross-over design. All patients had greater than 10% weight loss. Caloric intake was set at 1.7 times the resting energy expenditure (REE) as measured during the baseline period. The REE of patients with emphysema was 23 and 27% above that of the control group during baseline and refeeding periods, respectively. The increased REE was met primarily by an increased carbohydrate oxidation. During the infusion of D5W, N balance was lower in patients with emphysema, but during repletion N balance was similar in both groups of patients. Two weeks of nutritional support with either a CB or a FB diet increased body weight, N balance, and arm muscle area and improved maximal inspiratory pressure, skeletal muscle strength, and endurance-strength (using quadriceps, hamstring, and handgrip) to a similar degree in malnourished patients with and without lung disease. In other stress states, such as infection, it has been shown that hypermetabolism, hypercatabolism, and preferential fat oxidation occur concomitantly. Patients with emphysema are unusual because, althouth they are hypermetabolic, they are not hypercatabolic and do not demonstrate preferential fat oxidation.

UR - http://www.scopus.com/inward/record.url?scp=0023747440&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023747440&partnerID=8YFLogxK

M3 - Article

C2 - 3144207

AN - SCOPUS:0023747440

VL - 138

SP - 636

EP - 644

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

SN - 1073-449X

IS - 3

ER -