Nutritional support of the ventilator-dependent patient

A ventilator-dependent patient who is malnourished can develop infections, pulmonary edema, hypophosphatemia, decreased ventilatory drive, respiratory weakness, and atelectasis (because of lowered surfactant production). It is important to assess each patient's caloric needs individually, whether by use of predictive equations or by indirect calorimetry. Weaning of a patient from the ventilator can be difficult or impossible if the patient is malnourished, receives too much carbohydrate, or develops hypophosphatemia. Providing continuous fat emulsions as a source of energy can decrease the need for large amounts of glucose and can increase the likelihood of successful weaning.