Effectiveness of intensive nutritional regimes in patients who fail to wean from mechanical ventilation.

Over a 2-year period, 14 viable ventilator-dependent patients were transferred from the Medical Intensive Care Unit (MICU) to a general ward floor for nutritional support after failing to wean from mechanical ventilation (MV) while in the MICU. These patients were retrospectively grouped based on their ultimate ability to wean from MV: group 1 (N = 6) did not wean from MV and ultimately died in the hospital; group 2 (N = 8) weaned from MV and were eventually discharged. Before transfer from the MICU, the two groups did not differ with regard to serum albumin or transferrin levels, or in total lymphocyte count. After the period of aggressive nutritional support, group 2 patients showed an increase in serum albumin and transferrin whereas patients in group 1 showed a decrease. The differences between these groups were significant (p less than 0.05). The lymphocyte count did not change significantly. Ventilator-dependent patients who respond to nutritional support with an increase in protein synthesis are more likely to wean from mechanical ventilation than those who do not.