Chest
Clinical InvestigationsCOPDNutritional Support for Individuals With COPD
Section snippets
Search Strategy
RCTs were identified from several sources. Through the Cochrane Airways Group registry of RCTs in COPD, we searched MEDLINE (National Library of Medicine, from 1966 to 1998), EMBASE, and CINAHL (Cumulated Index to Nursing and Allied Health, from 1982 to 1998) for original articles published in all languages. The following terms were used to uncover trials related to nutritional support in COPD: Nutrit*, Malnutrit*, Undernourish*, Weight loss, Food, Feed, Diet*, Lean body mass, BMI, Depletion,
Results
A total of 272 abstracts were identified. After the two primary reviewers assessed the abstracts, the number was reduced to 55 reports closely related to nutrition and COPD (κ = 0.89; 95% CI, 0.82 to 0.96). These were read in detail. Of these studies, 34 were excluded (κ = 0.94; 95% CI, 0.85 to 1.00). Both reviewers agreed on all except four reports that were therefore sent to a third reviewer (Y.L.) for arbitration. Reports were excluded for the following reasons: uncontrolled study,9, 1123, 24
Discussion
Interest regarding weight loss among those with COPD has resulted in several trials of nutritional support, administered orally or by percutaneous gastrostomy.23 Unfortunately, some reported studies were not randomized or controlled.23, 2425, 26 We used a broad definition of nutritional support (any caloric supplementation> 2 weeks) to enable us to include as many trials as possible. In the nine interventions that were both randomized and controlled, we found the effect size to be consistently
ACKNOWLEDGMENT
We thank the authors of the original articles who provided data beyond that included in their published articles. We also thank the staff of the Cochrane “Airways Group” for their invaluable support and assistance.
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Cited by (0)
This study was made possible due to funding from FAPESP, Fundacao de Amparo a pesquisa do Estado de Sao Paulo, Brazil (I.M.F.), the Canadian Lung Association/MRC/Glaxo Welcome Postdoctoral fellowship (D.B.), and West Park Hospital Foundation.