Abstract
The objective of this study was to compare the effect of a high fat, low carbohydrate enteral feed with a standard isocaloric, isonitrogenous enteral feed on PaCO2 and ventilation time in patients with acute respiratory failure requiring artificial ventilation. 20 clinically stable patients requiring enteral feeding were randomized to either feed in a double-blind fashion. Initial ventilator standard settings were adjusted according to clinical state. Measurements including minute volume and arterial blood gases were made twice daily. Weaning was carried out according to set criteria. During the feeding period, PaCO2 just prior to weaning fell by 16% in the high fat group but increased by 4% in the standard feed group (p=0.003). The high fat group spent a mean of 62 h less time on the ventilator (p=0.006). A high fat, low carbohydrate enteral feed appears to be beneficial in patients undergoing artificial ventilation.
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References
Al-Saady NM (1987) The effects of changing inspiratory flow patterns on the mechanics of the respiratory system and gas exchange in patients undergoing intermittent postive pressure ventilation (IPPV). PhD, University of London
Angelillo VA, Bedi S, Durfee D, Dahl J, Patterson AJ, O'Donohue WJ (1985) Effects of low and high carbohydrate feeding in ambulatory patients with chronic obstructive pulmonary disease and chronic hypercapnia. Ann Intern Med 103:883
Askanazi J, Elwyn DH, Silverberg PA, Rosenbaum SH, Kinney JM (1980) Respiratory distress secondary to a high carbohydrate load. Surgery 87:596
Askanazi J, Weissman C, Rosenbaum SH, Hyman AI, Milic-Emili J, Kinney JM (1982) Nutrition and the respiratory system. Crit Care Med 10:163
Bassili HR, Dietel M (1981) Effect of nutritional support on weaning patients off mechanical ventilators. JPEN 5:161
Brown SE, Light RW (1983) What is now known about protein-energy depletion: when COPD patients are malnourished. J Respir Dis May: 36
Browning RJ, Olson AM (1961) The functional gastrointestinal disorders of pulmonary emphysema. Mayo Clin Proc 36:537
Covelli HD, Black JW, Olsen MS (1981) Respiratory failure precipitated by high carbohydrate loads. Ann Intern Med 95:579
Doekel RC, Zwillich CW, Scoggin CH (1976) Clinical semistarvation: depression of hypoxic ventilatory response. N Engl J Med 295:358
Fleisch A (1951) Le metabolisme basal standard et sa determination au moyer du “Metabocalculator”. Helv Med Acta 18:23
Garfinkel F, Robinson RD, Price C (1985) Replacing carbohydrate calories with fat calories in enteral feeding for patients with impaired respiratory function. JPEN 9:106
Lathrop JC, Bommarito A, Letson JA, Boysen DA, Gruenberg JC (1986) The effects of a high fat enteral feeding formula on patients requiring mechanical ventilation. Pharm Pract News Sep: 32
Mitchell RS, Petty TL (1982) Chronic obstructive pulmonary disease (COPD). In: Mitchell RS, Petty TL (eds) Synopsis of clinical pulmonary disease, edn 3. Mosby, St Louis
Putnam JS, Beecher CR (1976) Comprehensive care in chronic obstructive pulmonary disease. Primary Care 3:593
Robin AB, Askanazi J, Cooperman A (1981) Influence of hypercaloric glucose infusions on fuel economy in surgical patients: review. Crit Care Med 9:680
Suter PM (1983) Intermittent and continuous positive pressure ventilation. In: Tinker J, Rapin M (eds) Care of the critically ill patients. Springer, Berlin Heidelberg New York
Whipp BJ (1987) The control of exercise hyperpnoea. In: Whipp BJ (ed) The control of breathing in man. Physiological Society Guides No 3. University Press, Manchester
Wilmore DW (1977) The metabolic management of the critically ill. Plenum Medical Book Co, New York, p 164
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Al-Saady, N.M., Blackmore, C.M. & Bennett, E.D. High fat, low carbohydrate, enteral feeding lowers PaCO2 and reduces the period of ventilation in artificially ventilated patients. Intensive Care Med 15, 290–295 (1989). https://doi.org/10.1007/BF00263863
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DOI: https://doi.org/10.1007/BF00263863