Objectives: Most critically ill patients take dextrose saline which yields 3.4 Cal/g. Also, some ICU patients take propofol as sedative agents which yield 1.1 Cal/ml. Both dextrose and propofol can be significant sources of non-nutritional calorie (NNC). NNC may cause hypercapnia which can delay the weaning from ventilator and increase risk of multi-drug resistant (MDR) bacteria. The aim of this study is to evaluate the clinical impacts of NNCs) in mechanically ventilated critically ill patients who are also taking enteral nutrition.
Materials and Methods: We performed a retrospective analysis of patients admitted to the adult ICU.Collected data were analyzed by one-way ANOVA test followed by Tukey Kramer Post Hoc test to determine the mean differences of significant dependent variables between the Eucapnic (Group I), mild hypercapnic (Group II), moderate hypercapnic (Group III), and severe hypercapnic (Group IV). Risk of NNC associated hypercapnia were analyzed by chi square test.
Results: The mean overall age was 57.88±9.01 years, and 85 subjects (72.0%) were male. The overall risk of NNC associated hypercapnia was 74.58% (88 patients). Risk of mild hypercapnia (27.12%) was significantly higher in our study than either moderate hypercapnia (24.58%) or severe hypercapnia (22.88%).
Conclusion: NNCs may increase the risk of hypercapnia and subsequently ventilator weaning difficulties if g Carb: g Lipid ratio or %Carb Cal_TCI are also increased especially if the TCI exceeds TCR. As the PaCO2 level is increased, the weaning from ventilator and VFD chances are decreased and subsequently the risk of MDR bacteria of Acinetobacter, Pseudomonas, and Enterobacteriaceae are increased.
