Reduction in Serum CO2 During Hyperalimentation

Abstract

To the Editor.— Chan et al (220:1119, 1972) described the pH problem associated with administration of the hyperalimentation solutions. The first patient receiving hyperalimentation (750 ml of 5% dextrose-5% protein hydrolysate solution [C.P.H., Cutter Laboratories, Inc] with 350 ml of 50% dextrose in water [Cutter Laboratories, Inc]) at our institution exhibited progressively decreasing serum carbon dioxide concentrations. 1 The patient's serum carbon dioxide content was 30 mEq/liter at the time hyperalimentation was initiated. Over the next 12 days, the serum carbon dioxide progressively decreased to a nadir of 13 mEq/liter. It was thought that because the hyperalimentation solution had a high buffer capacity and a pH of 5.0 to 5.6 that it might have been depleting the body's buffer capacity. Therefore, the subsequent hyperalimentation solutions administered were adjusted to a pH of 7.0 with sterile 1N sodium hydroxide solution. Four days later the patient's carbon dioxide content had risen to