Page 212 - 84 human physiolofy part-1

Chapter 11

Nutrition for COPD (Chronic Obstructive Pulmonary

Disease) Patients

Nutrition is particularly important for ventilator-dependent patient. When metabolizing
macronutrients carbon dioxide and water are produced. The respiratory quotient (RQ) is a ratio of
produced carbon dioxide to amount consumed. Carbohydrates metabolism produces the most amount
of carbon dioxide so they have the highest (RQ). Fats produce the least amount of carbon dioxide along
with proteins. Protein has a slightly higher RQ ratio. It is recommended that this kind of patient not
exceed a 1.0 respiratory quotient (RQ). Lowering carbohydrates and supplementing fat or protein in the
diet might not result in maintaining the desired outcome because, excess amounts fat or protein may
also result in a respiratory quotient (RQ) higher than 1.0.

Case Study

Cystic Fibrosis

This disease is most common in Caucasians and will happen to 1 in every 2500 people. It is most
known for its effects on the respiratory tract although it does effect other systems as well. The
respiratory passages become clogged with a thick mucus that is difficult to expel even with vigorous
coughing. Breathing becomes difficult and affected individuals run the risk of choking to death on their
own secretions unless strenuous effort is made to clear the lungs multiple times every day. Victims
frequently will die in the 20's of pneumonia All of us secret mucus by certain cells in the epithelium
that line the respiratory passage ways. In normal cases the cells also secrete a watery fluid that will
dilute the mucus making it easier to pass through the airways. In cystic fibrosis that secretion of watery
fluid is impaired. This makes the mucus thicker and difficult to clear from the passageways. A recent
discovery found that in cystic fibrosis is caused by a defect in a type of chloride protein found in apical
membranes of epithelial calls in the respiratory system and elsewhere. This defect directly impedes the
chlorine ions transport, which will then indirectly effect the transport of potassium ions. This causes the
epithelium, to not create its osmotic gradient necessary for water secretion. It has been known for a
long time that cystic fibrosis is caused by a single abnormal gene. This gene codes for a portion of the
chloride channel protein.

Glossary

Acidosis: A fall in blood pH levels below 7.35.

Acute Bronchitis: an infection that is located in the primary and secondary bronchi, it is preceded
by a viral URI that lead to a secondary bacterial infection

Alkalosis: A rise in blood ph levels above 7.45.

Asthma: respiratory disease of the bronchi and bronchioles that symptoms include wheezing,
shortness of breath, and sometimes a cough that will expel mucus

Bronchial Tree: named because it has a series of respiratory tubes that branch off into smaller and

212 | Human Physiology