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Diet and Respiratory Failure

Arline G. Olim, MS, RD
JAMA. 1987;258(14):1894. doi:10.1001/jama.1987.03400140056021.
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To the Editor.—  In recent years, a great deal of attention has been paid to the findings that a high-fat, low-carbohydrate diet can help decrease serum carbon dioxide levels in hypercapnic patients1 and can decrease weaning time for patients who are mechanically ventilated.2 Pingleton and Harmon,3 in the conclusion to their article in the June 12 issue of JAMA, "Nutritional Management in Acute Respiratory Failure," stated that a diet consisting of 20% protein, 50% to 60% carbohydrate, and 20% to 30% fat was the ideal mixture of calories for most ventilated patients with respiratory failure. They cited the work of Askanazi.1 However, Askanazi has shown that diets with 50% of the nonprotein calories as fat emulsion reduce carbon dioxide production and thus the respiratory quotient (RQ). Therefore, the ideal diet consists of 20% protein, 50% to 60% fat, and 20% to 30% carbohydrate, which contradicts the


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