Chapter: Clinical Anesthesiology: Perioperative & Critical Care Medicine: Nutrition in Perioperative & Critical Care
Complications of Nutritional Support
COMPLICATIONS OF NUTRITIONAL SUPPORT
Diarrhea is a common problem with enteral feed-ings and may be related
to either hyperosmolarity of the solution or lactose intolerance. Gastric
disten-tion is another complication that increases the risk of regurgitation
and pulmonary aspiration; the use of duodenal or jejunostomy tubes should
decrease the likelihood of gastric distention. Complications of TPN are either
metabolic or related to central venous access (Table 53–1).
Bloodstream infections associated with central and peripheral venous lines
remain a major concern, particularly in the patient with critical illness and
immunocompromised states.
Overfeeding with excess amounts of glucose can increase energy
requirements and production of carbon dioxide; the respiratory quotient can be >1 because of lipogenesis.
Overfeeding can lead to reversible cholestatic jaundice. Mild elevations of
serum transaminases and alkaline phosphatase may reflect fatty infiltration of
the liver as a result of overfeeding.
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