| Popis: |
The association between weight loss and severe chronic obstructive pulmonary disease (COPD) has long been recognised. Fowler and Godlee [1] first described the association of weight loss and emphysema in the late nineteenth century. Attempts to establish different COPD classifications led to the realisation that body weight might be an important disease determinant [2]. This led to the classical description of the pink puffer (emphysematous type) and the blue bloater (bronchitic type). The pink puffing patient is characteristically thin, breathless, and with marked hyperinflation of the chest. The blue and bloated patient may not be particularly breathless, at least when at rest, but has severe central cyanosis. In the 1960s, several studies reported that low body weight and weight loss are negatively associated with survival in COPD [3]. Nevertheless, therapeutic management of weight loss and muscle wasting in patients with COPD has become of interest only recently, since these features were generally considered as terminal progression in the disease process and therefore inevitable and irreversible. |
