Nutritional needs

Background

IBW

1. male= 106 lbs + 6lbs for each inch over 60 +/- 10%.
2. 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% 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):

1. basal m25 f20
2. normal weight maintenance: m30 f25.
3. Ventilated m25-30 f same.
4. Stress m30-35 f same.
5. trauma/sepsis m35-40 f same
6. extremely catabolic 40-45

Protein Needs (g/kg)

1. maintenance .8
2. hospitalized 1-1.5
3. trauma/stress/sepsis 1.2-2
4. closed head injury 1.4-2.2
5. renal failure (without dialysis) .8^
6. renal failure (with dialysis) 1.2-1.5
7. liver disease with out encephalopathy 1.2-2.0
8. hepatic encephalopathy .6-.8^

^ may be greater with compounding medical conditions

Fluid Needs

• Intravenous fluids (main)

Sedated Patients

1. reduction in metabolic rate by as much as 30%.
2. propofol gives 1.1Kcal/cc
3. patients getting po dilantin should have their tube feeds held 1 hour prior to and 1 hour after it is administered.

See Also

• Nutrition (main)