Preporuke za prevenciju i liječenje pothranjenosti u bolesnika s kroničnom opstruktivnom plućnom bolesti [Recommendations for prevention and treatment of malnutrition in patients with chronic obstructive pulmonary disease]

Vrbica, Žarko and Vukić Dugac, Andrea and Popović Grle, Sanja and Jalušić Glunčić, Tajana and Jakopović, Marko and Bival, Sandra and Krznarić, Željko and Samaržija, Miroslav (2018) Preporuke za prevenciju i liječenje pothranjenosti u bolesnika s kroničnom opstruktivnom plućnom bolesti [Recommendations for prevention and treatment of malnutrition in patients with chronic obstructive pulmonary disease]. Liječnički vjesnik, 140 (7-8). pp. 183-189. ISSN 0024-3477

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Abstract

Chronic obstructive pulmonary disease (COPD) represents a significant public health problem with estimated prevalence of 10-15% in adult population in Croatia. COPD is a chronic inflammatory disease characterized by significant systemic disorders that can lead to poorer quality of life and increased morbidity and mortality. Protein- -energy malnutrition can be found in 25-40% of patients with COPD, with higher prevalence as disease progresses. Thus, COPD is defined as a multicomponent disease and treatment should be based on correction of all systemic disorders. Cachexia and muscle wasting is a frequent complication in COPD patients, an independent predictor of morbidity and mortality, and can accelerate frequency and severity of exacerbation. The aim of the Croatian Thoracic Society with these recommendations is to emphasize the importance of timely determination of the nutritional status of COPD patients by using a validated tool and defining a specific phenotype of patients. Adequate nutritional care needs to be provided in malnourished patients and those at risk of developing malnutrition.

Abstract in Croatian

Kronična opstruktivna plućna bolest (KOPB) velik je javnozdravstveni problem s prevalencijom od 10 do15% u Hrvatskoj. Osim oštećenja plućne funkcije, kod bolesnika nalazimo i znatne sustavne poremećaje koji mogu dovesti do povišenja morbiditeta i mortaliteta, kao i smanjenja kvalitete života. Proteinsko-energetska pothranjenost nalazi se kod 25 – 40% bolesnika oboljelih od KOPB-a, s višom prevalencijom u težim stupnjevima bolesti. Time se KOPB definira kao multikomponentna bolest te se i kvalitetno liječenje treba zasnivati na korekciji svih sustavnih poremećaja. Gubitak mišićne mase i snage respiratorne i skeletne muskulature svojstven je bolesnicima s KOPB-om te je neovisan prediktor mortaliteta koji povećava učestalost i težinu egzacerbacija. Hrvatsko torakalno društvo ovim preporukama želi naglasiti važnost pravodobnog utvrđivanja nutritivnog statusa bolesnika s KOPB-om uporabom validiranog alata te definiranjem specifičnog fenotipa bolesnika. Pothranjenim bolesnicima i onima u riziku od razvoja pothranjenosti potrebno je pružiti odgovarajuću nutritivnu skrb.

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