Total parenteral nutrition-induced cyclic hypercapnia.
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.
D004040:Dietary Carbohydrates / Q000008:administration & dosage; D006801:Humans; D006935:Hypercapnia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects* / Q000379:methods
D004040:Dietary Carbohydrates