Diet and Pulmonary

Diseases
By
Prof.Enayat Hashem

Nutrition and acute or chronic

respiratory failure interact in a variety of
ways.
The increased work of breathing in
respiratory failure increases energy
needs while dyspnea interferes with
nutrient intake, and these factors
contribute to weight loss and inadequate
nutrition status.

Malnutrition affects respiratory

function by causing :
1- Wasting of the diaphragm and intercostal
muscles
2- Decreased ventilatory response in
responsese to hypoxia
3- Decreased surfactant production
4- Decreased replication of respiratory
epithe- lium with predisposition of infection

5- Decreased cell-mediated immunity with

increased susceptibility to pneumonia
6- Decreased colloid osmotic pressure with
increased pulmonary edema
7- As phosphate is needed for adequate ATP,
so hypophosphatemia caused by malnutrit
ion will lead to impairment of respiratory
function

Chronic Obstructive Pulmonary

Diseases (COPD)

Asthma ( bronchospasm )

Bronchitis ( overproduction of mucus )

Emphysema (destruction of elastic lung tissue

with air trapping and poor gas exchange)

Bronchiectasis ( bronchial obstruction by

infection, foreign body, or tumor)

Nutritional Care of COPD

1) Increase kcal intake to compensate

weight loss and muscle wasting in COPD

2) Maintain ideal body weight

3) Frequent small meals to minimize

restriction of dighragm movement

4) Feeding between meals for underweight

patients

5) Supplement of antioxidants (Vit.A, E, C )

6) Bronchodilator and rest before meals to

decrease dyspnea

7) Walking is good exercise in COPD

Acute Respiratory Failure

This condition may be due to:

Increased pulmonary capillary pressure (e.g.

pneumonia, pulmonary edema)

Increased inadequate excretion of CO2 (e.g.

chronic bronchitis, emphysema)

Increased depression of respiratory center or

failure of neuromuscular transmission (e.g. drug
overdosage, spinal cord injury, multiple sclerosis)

Nutritional care for Acute

Respiratory Failure
In those ICU patients, it is easy to neglect
nutrition condition, so they are at high risk of
malnutrition.
So start nutritional support within the first 34 days of hospitalization to prevent
progression of malnutrition
Individuals given nutrition support are more
readily weaned from ventilators than those
given only intravenous (IV) glucose solutions.

1- Prevent or correct protein-caloric

malnutrition
Nutrient-dense foods for who able to eat
Nasogastric or nasoduodenal/nasojejunal feeding for who
unable to eat but with normal G.I.T.
TPN for who unable to eat and without normal G.I.T., but
avoid excessive amino acids asthey increase minute
ventilation and fatigue of respiratory muscle
Avoid aspiration of formula by ensuring that the tube is not
in the respiratory tract before administering feeding

2- Provide appropriate amount of

feeding

. Avoid uderfeeding or overfeeding

. Assess energy needs by calculating kcal
needs

3- Avoid fluid excess to avoid overhydration

4- Avoid lipid excess by assessing
serum triglycerides
5- Provide adequate antioxidants