Chronic Obstructive Pulmonary Disease COPD

1
Chronic Obstructive Pulmonary Disease (COPD)

• Chapter 38 Pages 945-948

2
Normal Lung Anatomy
3
COPD Factors

• Mortality from heart disease is decreasing in US
  but mortality from lung disease is increasing
• up about 3 per decade
• over 15 Billion/yr is costs
• Causes for COPD is multifactorial
• Definition persistent obstruction of air flow
  through the lungs

4
COPD 2 Types

• Emphysema
• Atrophy of lungs causing over-distention and
  stretching of lung tissue
• Chronic Bronchitis
• Inflamed Bronchi
• Primary Risk Factor smoking
• Other risks environmental pollution, secondary
  smoke, EtOH abuse, fam Hx, repeated respiratory
  tract infections

5
Emphysema

• Small passages and air sacs (alveoli) lose their
  elasticity
• Person has difficulty exhaling to remove air
  taken in during inhalation (dyspnea)
• increased CO2 trapped (hypercapnia)
• Lung expands to accommodate
• walls expand and thin out
• Destruction of elastin?

6
Chronic Bronchitis

• Excessive mucous production
• Clogs air passages (bronchioles)
• These become inflamed and add to the obstruction
• Chronic Bronchitis and Emphysema
• low O2 to tissues and increased CO2 in tissues
  and lungs

7
COPD Treatment

• No cure
• Lung transplant may be available for some
• Treatment aimed at relieving symptoms
• Nutrition no known nutrition cause
• Objectives involve achieving good nutritional
  status

8
COPD and Nutrition Status

• Weight loss, PC Malnutrition, and infection often
  accompany COPD
• Downward cycle
• weight loss effort to eat
• lungs and respiratory muscles loose mass
• decreased lung capacity
• decreased nutritional status
• increased pulmonary infections

9
Breathing and Energy Required

• Normal pulmonary function 36-72 kcal/day
• COPD Labored breathing 430-720 kcal/day
• 700 kcal/day x 7 days 4900 kcal/week/3500/
• 1.4 weight loss per week

10
Nutrition and Respiratory Failure

• Often candidates for TPN
• Use of low R.Q. foods
• high fat, low CHO diet
• Push high PUFA and MUFAs in diet
• To be anabolic may require 45 kcal/kg
• 30 to 50 Kcal from Fat
• 15 from PRO
• 40-45 from CHO