A study of intensified dietary support in underweight candidates for lung transplantation

Abstract

Background: No data is available on dietary intervention in candidates for lung transplantation and on the effect of different strategies for dietary support in this cohort.

Aim: We therefore wanted to evaluate the effects of intensified nutritional support compared with simple support on energy intake and nutritional status.

Method: Our participants were underweight (n = 42) and normal-weight (control group, n = 29) candidates for lung transplantation. The underweight patients were randomized into two groups. Group A received intensified dietary counselling, ready-made liquid nutritional supplements free of charge and regular follow-ups, while group B received only one session of individual dietary counselling, no supplements and no follow-ups.

Results: The mean intervention time was 21 weeks. Groups A and B both increased their energy intake and gained weight. Group A increased their energy intake from a median of 8.7 to 10.1 MJ (p < 0.01 compared with the control group after intervention) and gained a mean of 2.9 kg body weight (95% CI 1.2; 4.7, p = 0.005 compared with the control group), while group B increased from 7.4 to 10.8 MJ (p = 0.005) and gained 2.3 kg (1.2; 3.3, p = 0.002). Only group B increased their fat-free mass. In this group, an increase in O(2) saturation and a decrease in PaCO(2) were suggested. None of the groups improved its physical performance.

Conclusion: In candidates for lung transplantation we were unable to confirm the hypothesis that intensified nutritional support compared with a simple support increased compliance. Both groups achieved the goal for energy intake and gained weight.