Acute Respiratory Distress Syndrome: Metabolic Support

Nutritional support to ARDS patients shares metabolic concepts common to other categories of critically ill patients; however, it generates a particular concern due to the underlying limitation of oxygen supply and the difficulties of carbon dioxide disposal. In the present chapter, after shortly summarizing the pathophysiology of critical illness, stress response, and patients’ metabolic requirements, we will describe the characteristic features of artificial nutrition and metabolic support in patients with acute respiratory failure. We will underline the fact that, in patients with ARDS, several aspects of energy consumption physiology and of substrate supply, disposal and transformation, oxidation, and storage which, in the absence of respiratory failure may have a less relevant impact, have to be then carefully taken into account.