• Assessment
    What are the factors affecting energy needs in patients with COPD who are ambulatory/stable or during an exacerbation?
    • Conclusion

      Eighteen studies regarding energy needs in people with COPD were reviewed. The total daily energy needs of people with COPD are highly variable due to differences in resting energy expenditure and in levels of physical activity.  In stable COPD and during an exacerbation, the presence of inflammation increases resting energy expenditure. Further research on the influence of thermic effect of food, breathing efficiency and medications on energy needs in people with COPD is needed.           

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the relationship between weight loss and patients with COPD?
    • Conclusion

      Eight studies regarding weight and body composition in people with COPD were reviewed.  In people with COPD, the prevalence of malnutrition (as defined by a BMI less than 20 kg/m2) may be as high as 30%, and the risk of COPD-related death doubles with weight loss.  Even for the 70% with BMI greater than 20 kg/m2, body composition differs from healthy controls in that fat free mass index and bone mineral density are lower in people with COPD.  Further research is needed regarding the prognosis of people with COPD who have BMI greater than 20 kg/m2.  

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.