This study involved 15 chronic respiratory failure patients admitted to intensive care because of acute decompensation. Study of delayed hypersensitivity skin tests made it possible retrospectively to divide these patients into two groups according to whether tests were positive or negative. Group A: patient positive on admission and remaining so: or negative becoming positive on the 10th day = 8 patients. Group B: patient negative and remaining negative; or positive on admission and becoming negative on the 10th day = 7 patients. In group A, 7 patients survived, whilst one died of an intercurrent condition. In group B, all the patients died. Study of nutritional balance showed a deficiency in protein metabolism--with hypoproteinaemia, hypoalbuminaemia, decrease in creatine index, negative nitrogen balance--combined with a deficiency in trace elements. Such disturbances were particularly marked in group B. Under the influence of nutritional therapy, these deficiencies tended to return to normal in reacting subjects but worsened in non-reacting subjects. In patients of this type, nutritional therapy must be administered well before acute decompensation. It should be able to prevent the latter in a substantial number of cases.
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