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Reduction in resting energy expenditure following lung volume reduction surgery in subjects with chronic obstructive pulmonary disease

School of Physiotherapy, Faculty of Health Sciences, Sydney University, Australia;Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia;Department of Respiratory Medicine,Level 11 Edinburgh Building, Royal Prince Alfred Hospital, Missenden Rd,Camperdown, NSW, Australia 2050zoebw{at}med.usyd.edu.au

J A Alison

Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia

M S Bayfield

Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia

PTP Bye

Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia

Study objectives: Some subjects with COPD have an elevated resting energy expenditure (REE)which may be related to an increased work of breathing at rest. The purpose of this study was to examine the effect of lung volume reduction surgery (LVRS) on REE and body weight. Design: Ten subjects with COPD were recruited (mean age + SD = 61.4 + 6.1 years). At baseline (which was following preoperative pulmonary rehabilitation) and four months following LVRS (combined with postoperative pulmonary rehabilitation), each subject had tests of lung function, REE via indirect calorimetry using a canopy system, six minute walk distance (6MWD) and quality of life (QoL) using the St George's Hospital Respiratory Questionnaire (SGRQ). Measurements: The FEV, (% predicted) increased from 27.7 + 5.8% (mean + SD) at baseline to 33.9 + 7.8% following LVRS (P < 0.05). REE (% predicted) was 110 + 9.8% at baseline and decreased to 106 + 6.7% following LVRS (P = 0.04). Body mass index (BMI) following LVRS was unchanged (P = 0.67). No correlation between the change in BMI and change in REE was shown (r² = 0.3, P = 0.1). Therewas a significant improvement in QoL following LVRS (P < 0.001). 6MWD also significantly increased from 354 + 83 m to 412 + 82 m following LVRS (P = 0.001). Conclusion: Whilst there was an increase in lung function and a reduction in REE following LVRS, there was no corresponding change to body weight. The improvement in REE following LVRS may be related to an improvement in work of breathing.

Key Words: chronic obstructive • energy expenditure • exercise tolerance • pulmonary disease • thoracic surgery

Chronic Respiratory Disease, Vol. 1, No. 4, 197-202 (2004)
DOI: 10.1191/1479972304cd043xx


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