They aren’t going to ask you to make a TPN, but here’s some of the most basic info.
TPN Makeup
- Glucose should be 30-70%
- Fat should be 15-30%
- Protein: 1g/kg/day + stress (up to 2)
- Electrolytes
- I remember 50% glucose, 20% fat and 1g/kg of protein.
Caloric requirements:
- The dirty way to calculate caloric needs: 30 kcal/kg/day (+5 if critical, -5 is ok)
- Obtain weight before illness, use if within 20% of IBW. If 20-50% above, feed 25% of fat.
- Real BEE (Basal Energy Expenditure)
- male: 66+ (13.7 * weight in kg) + (5 * ht in cm) – (6.8 * age)
- female: 655+ (9.6 * weight in kg) + (1.7 * ht in cm) – (4.7 * age)
- Patient in renal failure need protein restriction unless on dialysis. They can receive 1.2-1.5 g/kg/day on dialysis.
Calorie Composition:
- Lipids/fats are 9 kcal/g
- Propofol is 1.1 kcal/mL
- Dextrose is 3.4 kcal/g
- Protein is 4 kcal/g