Published in:
01-09-2018 | Pulmonology and Respiratory Care (D Breen, Section Editor)
Muscle Wasting in the Hospitalised COPD Patients—How Can it Be Prevented and Treated?
Published in: Current Geriatrics Reports | Issue 3/2018
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Purpose of Review
COPD exacerbations are widely recognised as a significant cause of mortality and morbidity through their impact on respiratory function but their effect on skeletal muscle function and mass receives less attention. In this article, we review the association of this entity with COPD, the potential contributing factors, and the evidence behind the interventions available to manage this condition with a focus on the elderly population.
Recent Findings
In patients with COPD, there has been a paradigm shift from the focus on body weight and mass index to a more detailed assessment of the loss of muscle mass and function defined as sarcopaenia. Factors that can potentially lead to sarcopaenia has been the subject of multiple basic science and translational research studies. Interventions that have been proven to be associated with clinically significant outcomes in COPD patients include early mobilisation, inpatient exercise programmes, early pulmonary rehabilitation, and nutritional interventions. Prolonged courses of steroids following an acute exacerbation are non-beneficial and can lead to loss of muscle function.
Summary
Multiple factors can potentially contribute to sarcopaenia among patients admitted with COPD exacerbations and should be identified early and treated in a multidisciplinary setting. Nutritional interventions, early mobilisation, and limitation of systemic steroid prescribing are simple and effective interventions that should be utilised.