Adult Total Parenteral Nutrition ______________________________________ (1) Determine patient weight: Actual weight (wt)= weight on scale Ideal Body Weight (IBW): using height in inches, IBW in lbs: M: 106 + (Height-60)*6 F: 100 + (Height-60)*5 If wt >1.2* IBW, calculate adjusted body weight (ABW) = IBW + [wt-IBW]*(0.3 to 0.4) (2) Determine volume of TPN: consider: fluid requirements current IVF Use IVF+TPN for maintenance (3) Determine caloric requirements: 25-30 kcal/kg for previously well nourished patients 10 kcal/kg for severely malnourished. Advance, over 5 days to 20 kcal/kg (4) Protein: 1.0-1.5 g/kg for stressed pt. 1.0-2.0 g/kg for large surface area burns 0.5-0.8 g/kg for renal failure with mental status changes 20-25% total calories amino acids: 4 kcal/g 0.8 g/kg RDA [Maximum]= 50 g/l need 150-200 g (~700 kcal) of glucose to maximally utilize protein (5) Fat emulsion: 10-20% of total calories 10% provides 1.1 kcal/ml 20% provides 2.0 kcal/ml (6) Carbohydrate (dextrose): Remaining calories = [Total-(protein+lipid)] 3.4 kcal/g [Maximum]= 100 g/l Maximum load= 7g/kg/day excess dextrose -> increase LFTs (7) Electrolytes: Adjust based on daily labs Cu and Mn held with high bili Ca++/PO4- > 49 --> precipitate (8) Other additives: insulin, pepcid, MVI (9) Tables (compiled by R. Scott Hannay): Moderate stress TPN delivers: 1.5 g/kg protein per day 24 non-protein calories/kg/day 58% carbohydrates 42% lipid weights in kg, all dosing in grams WT DEXTROSE PROTEIN LIPID 50 205 75 50 55 226 83 55 60 246 90 60 65 267 98 65 70 287 105 70 75 308 113 75 80 328 120 80 85 348 128 85 90 369 135 90 95 389 143 95 100 410 150 100 105 430 158 105 110 451 165 110 115 471 173 115 120 492 180 120 Severe stress TPN delivers: 1.75 g/kg protein per day 28 non-protein calories/kg/day 64% carbohydrates 42% lipid WT DEXTROSE PROTEIN LIPID 50 265 88 50 55 292 96 55 60 318 105 60 65 345 114 65 70 371 123 70 75 398 131 75 80 424 140 80 85 451 149 85 90 477 158 90 95 504 166 95 100 530 175 100 105 557 184 105 110 583 193 110 115 610 201 115 120 636 210 120 START TPN@ 1/2 normal strength on the first day, then advance. ______________________________________ by Michael T. Milano, MD PhD MTMilano@yahoo.com www.geocities.com/MTMilano/palm/