Nutrition support for lung transplant patients.

Lung transplantation has emerged as an established and accepted therapy for patients with endstage pulmonary disease. Very little information has been published about the nutrition management of these patients during the period after transplantation. We conducted a retrospective review of the nutrition support records of 52 adult patients who had undergone lung transplantation at our institution. In addition to patient demographics, data were collected on baseline nutritional status, energy and protein goals, type of specialized nutrition support therapy, length of therapy, and incidence of metabolic complications. More than 50% of the patients receiving lung transplants had a diagnosis of cystic fibrosis. Compared with patients having other diagnoses, this group of patients had a greater incidence of malnutrition. The mean energy goal was 127 +/- 0.07% of basal energy expenditure, and the protein goal was 1.37% +/- 0.25 g/kg/d. All patients received parenteral nutrition therapy, which was begun by postoperative day 2 for more than 70% of the patients. Therapy was short-term (mean, 9 days), and patients then received oral diet. The most common metabolic complications were azotemia, hyperglycemia, and hypomagnesemia. Our experience should provide assistance to other health care professionals who are involved in the nutrition and metabolic management of patients undergoing lung transplantation.