Rose W
J Intraven Nurs. 1992 Jan-Feb;15(1):18-23.
Patients with chronic obstructive pulmonary disease (COPD) are generally malnourished. A catabolic state predisposes these patients to infection and a subsequent increase in mortality. Nutritional support may be mandatory to prevent visceral deterioration, but side effects of total parenteral nutrition (TPN) feeding can be harmful to patients with COPD. The use of glucose concentrates causes an increase of CO2, creating a metabolic demand for O2 that usually cannot be met. Specific formulas of TPN for COPD patients, using lipids for calories and limiting glucose, lower the respiratory quotient. There still remains a dilemma for adequate nutritional repletion, however, because all nutrients alter respiratory demand. Patients in acute respiratory failure or those requiring mechanical ventilation create a vital challenge for the health care provider.
慢性阻塞性肺疾病（COPD）患者通常存在营养不良。分解代谢状态使这些患者易发生感染，并随后增加死亡率。营养支持对于预防内脏功能恶化可能是必不可少的，但全胃肠外营养（TPN）喂养的副作用可能对COPD患者有害。使用高糖营养液会导致二氧化碳增加，产生对氧气的代谢需求，而这通常无法得到满足。针对COPD患者的TPN特定配方，使用脂肪提供热量并限制葡萄糖摄入，可降低呼吸商。然而，在实现充足的营养补充方面仍然存在困境，因为所有营养素都会改变呼吸需求。急性呼吸衰竭患者或需要机械通气的患者给医护人员带来了重大挑战。
