| CALCULATIONS FOR TOTAL PARENTERAL NUTRITION THERAPY - ADULT PATIENTS | ||
| Condition | Calorie Requirement (kcal/kg/d) | Protein Requirement (g/kg/d) |
| Resting state (adult medical patient) | 20-30 | 0.8-1 |
| Uncomplicated postop patients | 25-35 | 1-1.3 |
| Depleted patients | 30-40 | 1.3-1.7 |
| Hypermetabolic patients (trauma, sepsis, burns) | 35-45 | 1.5-2 |
| 1 g protein yields 4 kcal/g | ||
| 1 g fat yields 9 kcal/g | ||
| 1 g dextrose yields 3.4 kcal/g | ||
| 1 g nitrogen = 6.25 g protein | ||
| Electrolytes Required/Day | ||
| mEq/d | ||
| Sodium | 60-120 | |
| Potassium | 60-120 | |
| Chloride | 100-150 | |
| Magnesium | 24-Oct | |
| Calcium | 20-Oct | |
| Phosphate | 20-50 mmol/d | |
| Sulfate | 24-Oct | |
| Acetate | 60-150 | |
| Bicarbonate | Should not be added | |
| Estimated Fluid Requirements | ||
| 30-35 mL/kg/d | ||
| or | ||
| mL/d = 1500 mL for first 20 kg of body weight + 20 mL/kg for body weight >20 kg | ||
| Estimated Energy Requirements | ||
| Basal Energy Expenditure (BEE) | ||
| Harris Benedict equation | ||
| male | BEEmal = 66.67 + (13.75 x kg) + (5 x cm) - (6.76 x y) | |
| female | BEEfem = 665.1 + (9.56 x kg) + (1.85 x cm) - (4.68 x y) | |
| Total daily energy expenditure (TDE) | TDE = BEE x activity factor x injury factor | |
| Activity factor | Confined to bed = 1.2 | |
| Out of bed = 1.3 | ||
| Injury factor | Surgery: | |
| Minor operations = 1-1.1 | ||
| Major operations = 1.1-1.2 | ||
| Infection: | ||
| Mild = 1-1.2 | ||
| Moderate = 1.2-1.4 | ||
| Severe = 1.4-1.6 | ||
| Skeletal trauma = 1.2-1.35 | ||
| Head injury (treated with corticosteroids) = 1.6 | ||
| Blunt trauma = 1.15-1.35 | ||
| Burns | ||
| 20% body surface area (BSA) = 2 | ||
| 20%-30% BSA = 2-2.2 | ||
| >30% BSA = 2.2 | ||
| Return to Main Index | ||