Which of the following metabolic factors can hinder weaning? 1. Excessive carbohydrate feeding 2. Amino acid–based parenteral nutrition 3. Calorie intake = 1.5 ? resting energy expenditure (REE)
a. 2 and 3 only
b. 1 and 2 only
c. 1, 2, and 3
d. 1 and 3 only
ANS: B
Excessive carbohydrate feeding can increase carbon dioxide production and may precipitate acute hypercapnic respiratory failure. Parenteral nutrition solutions containing amino acid formu-lations (arginine/lysine) can cause metabolic acidosis and thus increase ventilatory demand.
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