[Artificial nutrition in respiratory failure]

Patients with chronic respiratory failure frequently have nutritional impairments that prompt nutritional support. This is more important during acute exacerbation episodes since, in this situation, the risk for hyponutrition is increased and recovery may be compromised. In order to prevent ventilatory overload, nutritional support should be normocaloric or mildly hypocaloric (using indirect calorimetry, if possible) with a fat content ratio of around 50% of the caloric intake. Micronutrients supply should be considered due to the effects of some of them (P, Mg, Se) on respiratory function. The aim of nutritional support in patients with acute respiratory failure (ARDS) is the requirements provision meanwhile the inflammatory response is modulated and repair mechanisms against acute damage are stimulated. Qualitative modification of lipids supply (by decreasing the intake of linoleic acid and increasing other eicosanoids-precursor lipids with a lesser inflammatory capability) and the use of antioxidants seem to be the most important mechanisms in this regard.