Nutrition Support Pulmonary

  1. S & S of overfeeding vented pt
    Increased CO2 (w/out preceding h/o COPD), which causes tachypnea so body maintains a normal pH.
  2. Kcal & pro provision for obese critically ill vented pts
    • 11-14 kcal/kg ABW or 60-70% of target.
    • BMI 20-40:  2 g/kg IBW.
    • BMI >40:  2.5 g/kg IBW.
  3. Kcal & pro provision for non-obese critically ill vented pts
    • Normal kcal.
    • 1.2-2 g/kg
  4. ASPEN guidelines for Pulmonary pts on PN?
    • OK to permissively underfeed a vented pt on PN (80% of goal initially). 
    • Withhold soy-based lipids in first week.
    • Supplement with IV glutamine.
  5. Pulmonary pts on EN or PN should receive aggressive replacement of what nutrient? What adjuvants?
    • Phos.
    • Enteral or IV Glutamine.
    • Fish oil/borage oil/antioxidant supplement (if ARDS),
  6. Additional considerations for types of formulas on EN vented patients?
    • Immune-modulating formulas may be used.
    • Consider fluid-restricted formula.
  7. Patients with what pulmonary dz may be appropriate for immunotherapy with omega-3 and antioxidants?
    ALI/ARDS (direct injury to lung via aspiration, pna, pulmonary contusion, fat emboli, smoke or toxic gas inhalation OR indirect lung injury via systemic inflammation- sepsis, traumatic shock, pancreatitis, cardiopulmonary bypass, blood transfusions)
Card Set
Nutrition Support Pulmonary