Tratamiento nutricional de pacientes con enfermedad pulmonar obstructiva crónica en situación de desnutrición
The purpose of this report is to evaluate the safety and efficacy/effectiveness of nutritional support (including ONS and EN) in patients with COPD already malnourished or at risk of malnutrition that cannot be reversed through the sole intake of ordinary food consumption. The aim was also to define the nutrient profile of the formulas used for the nutritional support of patients with COPD already malnourished or at risk of it. To meet the stated objective, a systematic review was performed to identify studies that had evaluated safety and efficacy/effectiveness of nutritional support (ONS and EN) in patients with COPD and malnutrition. Adult patients with a COPD diagnosis and malnutrition that could not be reversed through regular food consumption were considered as the study population. The study intervention was nutritional support (ONS and EN with nasoenteric tube, gastrostomy, or jejunostomy) performed in a hospital or outpatient setting. The usual treatment without nutritional supplement (ONS or EN), parenteral nutrition, placebo, and no intervention were considered as comparators. Outcome measures were related with safety (adverse events and process complications) and efficacy/effectiveness (mortality, morbidity, hospital admission rate, anthropometric measures, muscle function, respiratory function, adherence to treatment, and health-related quality of life). The study designs considered were systematic reviews and meta-analyses, comparative studies (randomised and controlled clinical trials, quasi-experimental studies, cohort studies, and case-control studies). The assessment of the quality of the studies was performed by analysing the risk of bias and applicability. Of the 241 references identified in the systematic review, 43 were selected for being potentially includible. After reading the complete text and applying the established inclusion and exclusion criteria, 35 studies were excluded.
Nutrition; Malnutrition; Chronic obstructive pulmonary disease; Treatment
Puigdomènech Puig E, Blanco Silvente L, Gallastegui Calvache E, Smith K, Romero Tamarit A, Espallargues Carreras M. Soporte nutricional de pacientes con enfermedad pulmonar obstructiva crónica en situación de desnutrición. Barcelona: Agència de Qualitat i Avaluació Sanitàries de Catalunya; 2021. (Informes de evaluación de tecnologías sanitarias).
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