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Informatics in Pharmacy

TPN: Total Parenteral Nutrition

August 12, 2018 By Dr. G, PharmD

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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

Filed Under: Fluid, Electrolytes, & Nutrition

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acid base acidosis acute coronary syndrome alkalosis analgesics anaphylaxis aortic dissection arrhythmia Beta-Blockers biostatistics blood pressure cardiac markers CHA2DS2-VasC cocaine COVID-19 diabetes diabetes inspidius Guidelines heart failure Heparin hypersensitivity hypertension hypovolemic shock intubation ionotropes journal club lipids LMWH medication safety morphine conversions myocardial infarction needs work NOAC NSTEMI obstructive shock pharmacoeconomics pheochromocytoma pressors reference materials right mi sedation septic shock shock STEMI Updated 2020