Total parenteral nutrition-induced cyclic hypercapnia
- 1 July 1988
- journal article
- case report
- Published by Wolters Kluwer Health in Critical Care Medicine
- Vol. 16 (7) , 727-728
- https://doi.org/10.1097/00003246-198807000-00016
Abstract
Excessive rates of carbohydrate infusion during total parenteral nutrition (TPN) have been reported to cause hypercapnia leading to respiratory failure or inability to wean from a ventilator. This case history illustrates the hitherto unreported syndrome of cyclic hypercapnia resulting from high rates of carbohydrate infusion during peak TPN flow rates when TPN was provided in a cyclic fashion. The patient was given TPN daily over an 18 1/2-h period followed by 5 1/2 h without nutritional support. Elevated CO2 production, increased respiratory quotient, hypercapnia, and inability to wean from a ventilator occurred during peak cycle TPN flow rates. When the same carbohydrate load was infused continuously over a 24-h period, CO2 production, respiratory quotient and PaCO2 were reduced. The patient was then able to tolerate periods of unassisted ventilation.Keywords
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