Mr. Page was placed on parenteral nutrition immediately postoperatively, and a nutrition support consult was ordered. Initially, he was prescribed to receive 200 g dextrose/L, 42.5 g amino acids/L, and 30 g lipid/L
His parenteral nutrition was initiated at 50 cc/hr with a goal rate of 85 cc/hr. Do you agree with the team's decision to initiate parenteral nutrition? Will this meet his estimated nutritional needs? Explain. Calculate: pro (g); CHO (g); lipid (g); and total kcal from his PN.
• Mr. Page was certainly malnourished prior to surgery.
• His surgery places his gastrointestinal function at risk. Mr. Page will be NPO for some time.
• The decision to use parenteral nutrition is correct.
• This formula prescription provides 2346 kcal and 86.7 g protein.
• This is slightly higher in both energy and protein than the lower calculated energy needs and will sufficiently nourish him.
Note: Calculations of parenteral nutrition are as follows:
• 2436 kcal : 64 kg = 36.7 kcal/kg
• 86.7 g amino acids : 64 kg = 1.4 g protein/kg
• Dextrose: 200 x 3.4 = 680 kcal/L. Total volume is 2040 mL, which would provide 1387.2 kcal.
408 g dextrose x 64 kg = 6.375 g/kg/day x 1000 mg/g x 1 day/1440 min = 4.4 mg dextrose/min
(4.3-7.2 mg/kg/min guideline for critically ill/stressed patients)
• Lipid: 30 g lipid/L @ 11 kcal/g: 673.2 kcal
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