Nutritional status of patients undergoing volume reduction surgery

A prospective evaluation

J. Turner, H. P. Wong, G. L. Sieven, M. Baker, A. G. Little

Research output: Contribution to journalReview article

Abstract

Purpose: Reduction pneumoplasty was described more than 35 years ago by Dr. Otto C. Brantigan. Recent revival of this operation with modern surgical technique including a thoracoscopic approach has been proposed as a treatment for incapacitating emphysema without giant bullous disease and as a possible bridge to lung transplantation in some of these patients. Although we assume that this population of patients are representative of the general population of those with COPD, no-one has yet prospectivly looked at the nutritional status of this operative group. We, therefore, performed a pilot study involving the prospective collection of data regarding the nutritional status of patients undergoing thoracoscopic reduction pneumoplasty for severe incapacitating emphysema. Methods: Twenty-seven patients elected to undergo thoracoscopic reduction pneumoplasty. These patients had been referred by their pulmonary physicians to the University of Nevada Department of Surgery for this procedure owing to severe symptomatic COPD. Upon admission and during hospitalisation nutritional measurements were taken. Analysis of variance on these variables were then performed comparing preoperative values with those obtained on postoperative days 3 & 5. Results: We found evidence of nutritional depletion in these subjects. Total protein, albumin, cholesterol, pre-albumin, transferrin, percent lymphocytes and total lymphocyte counts showed a significant decline in concentration. The decline in plasma proteins was significant with p values of 0.0134. On admission measurable deficits were also noted in muscle mass and fat stores. Conclusions: This is the first report we are aware of that has specifically looked at multiple nutritional variables in this population of patients referred for volume reduction surgery. Our prospective study confirmed that those patients being referred for lung reduction surgery have nutritional depletion reflective of prolonged malnutrition. Clinical Implications: Lung reduction surgery is now undergoing evaluation as a treatment option in certain patients with emphysema. Our study demonstrates that this select population reflects the underlying malnutrition present in many emphysematous patients. In-depth nutritional evaluation should be routinely performed in these patients as an important preoperative determinant and postoperative treatment imperative.

Original languageEnglish (US)
JournalChest
Volume110
Issue number4 SUPPL.
StatePublished - Oct 1 1996
Externally publishedYes

Fingerprint

Nutritional Status
Emphysema
Malnutrition
Lung
Chronic Obstructive Pulmonary Disease
Population
Albumins
Patient Advocacy
Lung Transplantation
Lymphocyte Count
Transferrin
Blood Proteins
Analysis of Variance
Hospitalization
Therapeutics
Fats
Cholesterol
Prospective Studies
Lymphocytes
Physicians

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Turner, J., Wong, H. P., Sieven, G. L., Baker, M., & Little, A. G. (1996). Nutritional status of patients undergoing volume reduction surgery: A prospective evaluation. Chest, 110(4 SUPPL.).

Nutritional status of patients undergoing volume reduction surgery : A prospective evaluation. / Turner, J.; Wong, H. P.; Sieven, G. L.; Baker, M.; Little, A. G.

In: Chest, Vol. 110, No. 4 SUPPL., 01.10.1996.

Research output: Contribution to journalReview article

Turner, J, Wong, HP, Sieven, GL, Baker, M & Little, AG 1996, 'Nutritional status of patients undergoing volume reduction surgery: A prospective evaluation', Chest, vol. 110, no. 4 SUPPL..
Turner J, Wong HP, Sieven GL, Baker M, Little AG. Nutritional status of patients undergoing volume reduction surgery: A prospective evaluation. Chest. 1996 Oct 1;110(4 SUPPL.).
Turner, J. ; Wong, H. P. ; Sieven, G. L. ; Baker, M. ; Little, A. G. / Nutritional status of patients undergoing volume reduction surgery : A prospective evaluation. In: Chest. 1996 ; Vol. 110, No. 4 SUPPL.
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AU - Little, A. G.

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