Aggressive Nutrition Therapy in a Rehabilitation Hospital for Severe Tachypnoea and Profound Weight Loss With Interstitial Lung Disease: A Case Report.

A 67-year-old male suffering from polymyositis-associated interstitial lung disease (ILD) was transferred to a rehabilitation hospital. Upon admission, the patient presented with severe malnutrition (weight of 32.0 kg; BMI of 12.10 kg/m2; skeletal muscle index of 3.8 kg/m2) and rapid shallow breathing with pronounced exercise-induced tachypnoea. The patient underwent physiotherapy, which included belt electrode skeletal muscle electrical stimulation and progressively titrated aerobic/resistance training. Following the initial stepwise optimisation for transient poor intake, an aggressive nutrition therapy was started. At discharge, the patient gained 4.6 kg in weight, with an increase in skeletal muscle mass from 13.9 to 15.5 kg. The skeletal muscle index had increased to 4.4 kg/m2, representing an increase of 0.6 kg/m2. Furthermore, the duration of continuous aerobic exercise had increased to 30 min, representing a 27-min increase. This case may present a pragmatic strategy for the implementation of aggressive nutrition therapy during rehabilitation for tachypnoeic ILD.