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August 14, 1972

Reduction in Serum CO2 During Hyperalimentation

Author Affiliations

Public Health Service Hospital Baltimore

JAMA. 1972;221(7):716. doi:10.1001/jama.1972.03200200062033

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