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Metabolic acidosis during parenteral nutrition: Pathophysiological mechanisms

Total parenteral nutrition (TPN) is associated with metabolic complications including metabolic acidosis (MA), one of the main disorders of acid-base balance. The main causes involved in the appearance of MA during TPN administration are the metabolism of cationic amino acids and amino acids contain...

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Autores principales: Dounousi, Evangelia, Zikou, Xanthi, Koulouras, Vasilis, Katopodis, Kostas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430745/
https://www.ncbi.nlm.nih.gov/pubmed/25983433
http://dx.doi.org/10.4103/0972-5229.156473
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author Dounousi, Evangelia
Zikou, Xanthi
Koulouras, Vasilis
Katopodis, Kostas
author_facet Dounousi, Evangelia
Zikou, Xanthi
Koulouras, Vasilis
Katopodis, Kostas
author_sort Dounousi, Evangelia
collection PubMed
description Total parenteral nutrition (TPN) is associated with metabolic complications including metabolic acidosis (MA), one of the main disorders of acid-base balance. The main causes involved in the appearance of MA during TPN administration are the metabolism of cationic amino acids and amino acids containing sulfuric acid (exogenous addition), the titratable acidity of the infused parenteral solution, the addition of acidificant agents (hydrochloric acid, acetic acid), thiamine deficiency, disruption of carbohydrate and lipid metabolic pathways and D-fructose administration. Moreover, hypophosphatemia that appears during TPN therapy contributes significantly to the maintenance of MA. This review describes in a comprehensive way the pathophysiological mechanisms involved in the appearance of MA induced by intravenous administration of TPN products most commonly used in critically ill-patients.
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spelling pubmed-44307452015-05-15 Metabolic acidosis during parenteral nutrition: Pathophysiological mechanisms Dounousi, Evangelia Zikou, Xanthi Koulouras, Vasilis Katopodis, Kostas Indian J Crit Care Med Review Article Total parenteral nutrition (TPN) is associated with metabolic complications including metabolic acidosis (MA), one of the main disorders of acid-base balance. The main causes involved in the appearance of MA during TPN administration are the metabolism of cationic amino acids and amino acids containing sulfuric acid (exogenous addition), the titratable acidity of the infused parenteral solution, the addition of acidificant agents (hydrochloric acid, acetic acid), thiamine deficiency, disruption of carbohydrate and lipid metabolic pathways and D-fructose administration. Moreover, hypophosphatemia that appears during TPN therapy contributes significantly to the maintenance of MA. This review describes in a comprehensive way the pathophysiological mechanisms involved in the appearance of MA induced by intravenous administration of TPN products most commonly used in critically ill-patients. Medknow Publications & Media Pvt Ltd 2015-05 /pmc/articles/PMC4430745/ /pubmed/25983433 http://dx.doi.org/10.4103/0972-5229.156473 Text en Copyright: © Indian Journal of Critical Care Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Dounousi, Evangelia
Zikou, Xanthi
Koulouras, Vasilis
Katopodis, Kostas
Metabolic acidosis during parenteral nutrition: Pathophysiological mechanisms
title Metabolic acidosis during parenteral nutrition: Pathophysiological mechanisms
title_full Metabolic acidosis during parenteral nutrition: Pathophysiological mechanisms
title_fullStr Metabolic acidosis during parenteral nutrition: Pathophysiological mechanisms
title_full_unstemmed Metabolic acidosis during parenteral nutrition: Pathophysiological mechanisms
title_short Metabolic acidosis during parenteral nutrition: Pathophysiological mechanisms
title_sort metabolic acidosis during parenteral nutrition: pathophysiological mechanisms
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430745/
https://www.ncbi.nlm.nih.gov/pubmed/25983433
http://dx.doi.org/10.4103/0972-5229.156473
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