Study objectives: Malnutrition and low body weight are
common in patients with emphysema. Previous work has demonstrated
correlation between severity of airflow obstruction and body weight.
Lung volume reduction surgery (LVRS) is a recent advance in the
treatment of patients with severe emphysema that results in improved
pulmonary function. We formed the hypothesis that improved lung
mechanics after LVRS would result in body weight gain.
Design: Retrospective chart review.
Patients: All patients who underwent bilateral LVRS for
severe emphysema at the University of Michigan between January 1995 and
April 1996 were eligible for the study.
results: Pulmonary function and body weight were measured
preoperatively and at 3, 6, and 12 months postoperatively for patients
who underwent bilateral LVRS between January 1995 and April 1996. The
average weight gain in 38 patients returning for 12 months of follow-up
was 3.8 ± 0.9 kg, or 6.2% of the preoperative weight. Women gained
significantly more weight than men (9.2 vs 2.2%, respectively) at 1
year. Interestingly, there was no correlation between change in weight
and postoperative change in FEV1, FVC, residual volume
(RV), total lung capacity (TLC), or RV/TLC at 12 months. However, there
was a statistically significant correlation between weight gained and
improvement in diffusion of carbon monoxide measured 12 months
Conclusions: This study shows that
patients with severe emphysema gain weight after LVRS. These changes
were independent of changes in pulmonary mechanics but may be a result
of improved gas exchange. These findings provide further information
about benefits of LVRS in patients with advance emphysema that are
beyond simple changes in pulmonary function.