호흡부전 환자에서 성공적인 인공호흡기 제거를 위한 영양공급
Nutritional Support for Successful Ventilator Weaning in Patients with Respiratory Insufficiency
정성엽, 봉진구, 이윤식, 박진현,
소속 상세정보
정성엽 ( Jeong Seong-Yeob )
왈레스기념 침례병원 외과
봉진구 ( Bong Jin-Gu )
왈레스기념 침례병원 외과
이윤식 ( Lee Yun-Sik )
왈레스기념 침례병원 일반외과
박진현 ( Park Jin-Hyun )
왈레스기념 침례병원 일반외과
KMID : 0371320010610020203
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.
키워드
고탄산혈증; 영양공급; 지방; TNA; Hypercapnia; Nutritional support; Fat; TNA (total nutrients admixture);
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