High fat, low carbohydrate, enteral feeding in patients weaning from the ventilator

Abstract

Objective: To study whether high fat, low carbohydrate enteral nutrition could reduce {Mathematical expression} in patients during ventilator support and weaning from the ventilator in order to facilitate the weaning process. Design: Prospective, randomized controlled study. Setting: Medical ICU of a university hospital. Patients: 32 ventilator-dependent patients with a prospect of weaning from mechanical ventilation. Interventions: High fat feeding administered to 15 patients and standard isocaloric feeding administered to 17 patients, both in a dosage of 1.5 times basal metabolic rate. Measurements and results: Respiratory and metabolic measurements were obtained both during mechanical ventilation and weaning procedures. High fat feeding was associated with significantly lower RQ values compared with standard feeding; the mean (±SEM) RQ values during mechanical ventilation amounted to 0.91±0.01 and 1.00±0.02 and during weaning to 0.72±0.02 and 0.86±0.02 for high fat and standard nutrition respectively (both p-values<0.001). High fat feeding reduced the CO2-excretion both during mechanical ventilation and weaning, but only the decrease during weaning proved to be significant; the mean (±SEM) CO2-excretion amounted to 0.177±0.010 and 0.231±0.011 l/min STPD for the high fat and standard feeding respectively (p<0.01). No significant differences were found in the PaCO2 during weaning between the two feeding groups. Conclusion: High fat, low carbohydrate enteral feeding significantly reduced the RQ values in ventilated patients with decreases {Mathematical expression}, but in this study failed to reduce PaCO2 during weaning from the ventilator. © 1994 Springer-Verlag.