ABSTRACT
Consideration of the nutritional status of patients with acute respiratory failure and mechanical ventilation is important for effective patient assessment and management. Patients with acute respiratory failure are at a high risk for developing malnutrition. High glucose intakes given during the administration of total parenteral nutrition (TPN) have been demonstrated to increase CO2 production. The workload imposed by the high CO2 production may precipitate respiratory distress in patients experiencing compromised pulmonary function. The authors report a case of successful weaning from mechanical ventilation in patient with post-operative ARDS by proper nutritional support and by changing the proportion of calories derived from carbohydrates and fats. Substitution of fat calories for carbohydrate in TNA solutions can reduce CO2 production and help wean patients from mechanical ventilation. Conclusively, the TNA (total nutrients admixture) system is more beneficial to patients with acute respiratory failure due to less CO2 production and surfactant production than TPN. For patients with hypercapnia, providing 25% to 30% of calories as carbohydrate and 50% to 55% of calories from fat may be beneficial.