The patient was also receiving propofol. What is this, and why should it be included in an assessment of his nutritional intake? How much energy (total kcal, %kcal from fat)did it provide?
What will be an ideal response?
Propofol is a lipid-soluble, short-acting IV hypnotic/sedative that is administered continuously to provide sedation in mechanically ventilated patients. It has a similar composition to a 10% lipid emulsion that provides 1.1 kcal/mL from fat. The calories provided by this sedative may be ignored by the medical team, but the amount of propofol administered to patients can be substantial and therefore can provide a lot of calories. If these calories are not accounted for with the patient's nutrition support, it can result in overfeeding. Thus, these calories provided from propofol should be part of the total energy intake in mechanically ventilated ICU patients. Mr. Perez received an additional 924 kilocalories from propofol, which is about 25% of his needs according to his metabolic cart on day 4 . Because this medication is providing a large amount of energy, it is important to monitor its delivery and adjust the nutrition support according to clinical course as appropriate.
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