Physiologic response and clinical implications of nutrition support

Cardiopulmonary complications such as sudden death, congestive heart failure and hypercapnia are now recognized to punctuate the refeeding course of malnourished hospitalized patients; these effects in particular occur early in the recovery period. Data that indicate a time-dependent dose and composition effect of continuously infused formula on gas exchange, metabolic rate, ventilation and cardiac-related indexes are discussed. Unlike the interrupted feeding of regular meal ingestion, continuous feeding produces a sustained physiologic response. Delineation of continuous feeding effects on host metabolism provides a rational basis for managing the untoward cardiac and pulmonary complications of nutrition support.