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Intensive Care Medicine

, Volume 14, Issue 3, pp 206–211 | Cite as

Metabolic and respiratory effects of enteral nutrition in patients during mechanical ventilation

  • B. van den Berg
  • H. Stam
Original Articles

Abstract

The effect of enteral feeding on O2-consumption (\(\dot V_{O_2 } \)) and CO2-production (\(\dot V_{CO_2 } \)) was studied in 9 ventilator-dependent patients, who were in a stable condition without signs of hypermetabolism. Resting energy expenditure (REE) in postabsorptive state was assessed and enteral feeding was started by continuous drip (480 kcal carbohydrate, 360 kcal vegetable fat and 160 kcal milkprotein: 6.4 g Nitrogen/ 1000 ml). Patients were given a moderate and a high caloric intake: 1.5 and 2.0 times REE.\(\dot V_{O_2 } \) and\(\dot V_{CO_2 } \) were measured for a 24 h period, beginning 7 h after the start of the dietary intake. Significant greater increases in\(\dot V_{O_2 } \),\(\dot V_{CO_2 } \) and RQ were found during high caloric intake compared with the moderate caloric intake.\(\dot V_{O_2 } \),\(\dot V_{CO_2 } \) and arterial blood-gases were measured in 4 patients during weaning from the ventilator. The increase in\(\dot V_{CO_2 } \) induced by the high caloric feeding resulted in a rise in arterial CO2 tension (PaCO2) and respiratory distress. High caloric enteral nutrition can cause a significant increase in\(\dot V_{CO_2 } \) inducing respiratory distress during weaning from the ventilator in patients with limited pulmonary reserves. Moderate caloric nutrition will be preferable to these patients in order to facilitate the weaning.

Key words

Metabolic measurements Enteral nutrition Mechanical ventilation Weaning from the ventilator 

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Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • B. van den Berg
    • 1
  • H. Stam
    • 2
  1. 1.Intensive Care Unit of the Department of Internal Medicine, University HospitalErasmus UniversityRotterdamThe Netherlands
  2. 2.Department of Pulmonary Diseases, University HospitalErasmus UniversityRotterdamThe Netherlands

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