Chest, Vol 102, 551-555, Copyright © 1992 by American College of Chest Physicians

ARTICLES

Nutritionally associated increased carbon dioxide production. Excess total calories vs high proportion of carbohydrate calories

SS Talpers, DJ Romberger, SB Bunce and SK Pingleton
Division of Pulmonary Disease, University of Kansas Medical Center, Kansas City.

This study compared carbon dioxide production (VCO2) from isocaloric nutritional regimens with varying concentration of carbohydrates with VCO2 from low and high caloric nutritional regimens with constant concentrations of carbohydrates (CHO) in 20 stable mechanically ventilated patients. Ten patients (group A) received total parental nutrition in the form of three isocaloric nutritional regimens; 40 percent CHO/40 percent fat/20 percent protein, 60 percent CHO/20 percent fat/20 percent protein, and 75 percent CHO/5 percent fat/20 percent protein. The VCO2 did not change with increasing CHO proportion; 205 +/- 35 ml/min, 203 +/- 25 ml/min, and 211 +/- 35 ml/min, respectively. Ten additional patients (group B) received three nutritional regimens at 1.0, 1.5, and 2.0 times the estimated resting expenditure with a 60 percent CHO/20 percent fat/20 percent protein proportion. The VCO2 increased with increasing total calories, 181 +/- 23 ml/min, 211 +/- 38 ml/min, and 244 +/- 40 ml/min (p less than 0.05). High caloric feeding increases VCO2 in contrast to high percentage carbohydrate formulation. Thus, moderate caloric intake appears to be more important in avoiding nutritionally related increases in VCO2 in stable mechanically ventilated patients.

This article has been cited by other articles:

				G. Chaiban, H. Hanna, T. Dvorak, and I. Raad A rapid method of impregnating endotracheal tubes and urinary catheters with gendine: a novel antiseptic agent J. Antimicrob. Chemother., January 1, 2005; 55(1): 51 - 56. [Abstract] [Full Text] [PDF]

				C. R. Parrish and S. F. McCray Nutrition Support for the Mechanically Ventilated Patient Crit. Care Nurse, February 1, 2003; 23(1): 77 - 80. [Full Text] [PDF]

				Members of the Task Force:, E. Bouza, C. Brun-Buisson, J. Chastre, S. Ewig, J-Y. Fagon, C.H. Marquette, P. Munoz, M.S. Niederman, L. Papazian, et al. Ventilator-associated pneumonia: European Task Force on ventilator-associated pneumonia Chairmen of the Task Force: A. Torres and J. Carlet Eur. Respir. J., May 1, 2001; 17(5): 1034 - 1045. [Full Text] [PDF]

				M. P. Siegenthaler, K. M. Pisters, K. W. Merriman, J. A. Roth, S. G. Swisher, G. L. Walsh, A. A. Vaporciyan, W. R. Smythe, and J. B. Putnam Jr Preoperative chemotherapy for lung cancer does not increase surgical morbidity Ann. Thorac. Surg., April 1, 2001; 71(4): 1105 - 1112. [Abstract] [Full Text] [PDF]

				O. Mimoz, A. Karim, J. X. Mazoit, A. Edouard, S. Leprince, and P. Nordmann Gram staining of protected pulmonary specimens in the early diagnosis of ventilator-associated pneumonia Br. J. Anaesth., November 1, 2000; 85(5): 735 - 739. [Abstract] [Full Text] [PDF]

				D. WERMERT, C.-H. MARQUETTE, M.-C. COPIN, F. WALLET, A. FRATICELLI, P. RAMON, and A.-B. TONNEL Influence of Pulmonary Bacteriology and Histology on the Yield of Diagnostic Procedures in Ventilator-Acquired Pneumonia Am. J. Respir. Crit. Care Med., July 1, 1998; 158(1): 139 - 147. [Abstract] [Full Text] [PDF]