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Cystic Fibrosis (CF) and respiratory disease (COPD) - Coggle Diagram
Cystic Fibrosis (CF) and respiratory disease (COPD)
Anthro
wt, wt hx
BMI
wt loss, wt gain
FFM (fat free mass)
Fat-free mass (FFM) is the most important determinant of basal metabolic rate. When indirect calorimetry
is not available to evaluate REE, the second best option is to measure FFM
Biochem
genetic testing
new born screening
heel prick test
Clinical
medical hx
diabetes
Glucose intolerance in CF
family hx
diabetes
smoking status
age
sex
CONSIDER
Individualised diet management to suit health status
Review of GI /or liver problems
Screening & treatment of CFRD
CF Bone Disease – prevention and treatment
Nutritional support
guidelines
FEEDS
ESPEN
Cystic Fibrosis NHMRC
Symptoms
COPD
SOB
Chronic Cough
Chronic Sputum production
episodes of acute worsening of said symptoms
infective in nature
Wt loss, wt gain
recurrent infections
anorexia
fatigue
malnutrition
early satiety
inactivity
diabetes
GERD
CF
early satiety
SOB, Wheezing
Recurrent infections
dry mouth
Foul-smelling, bulky greasy stools
Malabsorption
Loose stools
large stools
greasy/ floating stools
foul smelling
frequent trips to the bathroom
excess gas
bloated stomach
stomach cramps/ pains
weight loss
Diet/ intervention
check calcium and vit D
monitor for malnutrition
enteral feeding
can achieve nutritional requirements and maintain healthy weight for height (BMI 20-25kg/m2) by increasing energy density of diet
PERT (Malabsorption) and fat matching
A balanced quality diet supplemented with fat soluble vitamins (A,D,E,K) and additional sodium to meet individual energy demands accompanied by adequate provision of PERT to match dietary fat intake is required to achieve adequate nutritional status
Fat, Sodium, Energy
omega-3 fatty acids may be beneficial for preventing or treating symptoms of
COPD due to their anti-inflammatory effects
Nutritional Requirements
COPD
Moderately Hypermetabolic 125-145 kJ/kg/day; 1.2 – 1.5 g protein/kg/day
Frequent small amounts of ONS preferred (AVOID postprandial dyspnoea and satiety & improve compliance)
no additional advantage of disease specific low CHO, high fat ONS compared to high protein or high energy ONS
CF
energy requirements: Schofield with physical activity and injury factor added
Increased Energy
Chronic lung inflammation and infections. Increased work of breathing and coughing. stimulation of metabolism by Bronchodilator therapy.
Maldigestion, malabsorption and other losses
Exocrine pancreatic insufficiency, reduced bile salts, increased intestinal mucus
inadequate intake
Poor appetite worsened by infection
related anorexia, Behavioral Factors
All lead to Energy Deficits which lead to weight loss which impacts deterioration of lung function.
Salt Replacement Therapy and
hydration
