Nutritional needs

Background

IBW-male= 106 lbs + 6lbs for each inch over 60 +/- 10%.

female=100 plus 5 lbs for each inch over 60 +/- 10%

adjusted body wt.=(actual-IBW) x.25 + IBW. Use for people whose abw is greater than 120 percent ibw ...or BMI greater than 25.

Kcal needs is based on adjusted body weight, but protein needs is based on ideal body weight.

Kcal Needs(kcal/kg):

basal m25 f20

normal weight maintenance: m30 f25.

Ventilated m25-30 f same.

Stress m30-35 f same.

trauma/sepsis m35-40 f same

extremely catabolic 40-45

Protein Needs (g/kg)

maintenance .8

hospitalized 1-1.5

trauma/stress/sepsis 1.2-2

closed head injury 1.4-2.2

renal failure (without dialysis) .8*

renal failure (with dialysis) 1.2-1.5

liver disease w/o encephalopathy 1.2-2.0

hepatic encephalopathy .6-.8*

• may be greater with compounding medical conditions

Fluid Needs

adults 30 cc/kg

elderly 25cc/kg

Sedated Patients

reduction in metabolic rate by as much as 30%.

propofol gives 1.1Kcal/cc

patients getting po dilantin should have their tube feeds held 1 hour prior to and 1 hour after it is administered.