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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Bibliographic Details
Published in:Indian journal of critical care medicine 2015-05, Vol.19 (5), p.270-274
Main Authors: Dounousi, Evangelia, Zikou, Xanthi, Koulouras, Vasilis, Katopodis, Kostas
Format: Article
Language:English
Subjects:
Acidosis
Amino acids
Causes of
Complications and side effects
Diabetes
Hydrochloric acid
Kidneys
Malnutrition
Medical research
Metabolic disorders
Mortality
Nutrition
Parenteral nutrition
Pathological physiology
Review
Sulfur
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Summary: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.
ISSN:0972-5229
1998-359X
DOI:10.4103/0972-5229.156473