dg
2006-11-03T00:25:57Z
2008-08-09T17:24:15Z
10.6735
12354
TPN calculator3_12354
SourceWorkbook
HtmlCalc
8385
15360
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| SJMC TPN Calc - by David Gilbert |
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| fill in bolded fields - yellow = fill in on TPN order sheet |
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| 100 |
Pt kg |
250 |
fat vol |
| 25 |
kcal/kg |
1550 |
vol |
| 1800 |
desired mL/d |
125 |
prot gram |
| 1.25 |
Prot (g/kg/d) |
500 |
prot kcal/d |
| 500 |
kcal fat |
600 |
dirovan kcal |
| 24 |
diprovan rate |
480 |
kcal carb |
| 9.1081593927893749 |
D-conc % |
141.1764705882353 |
carb gm |
| 75 |
calc drip rate |
2500 |
tot kcal/d |
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| TPN tips |
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| total kcal/d (max 2500) |
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| mild stress - 20-25 |
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| ICU pt - 25-30 |
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| BMI >30: 15-20 |
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| BMI <20: 30-40, sev stress 30-40 |
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| Amino Acids |
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| Its hard to give too much unless in renal failure. |
| If BUN goes above 70, back off. |
| Normal 0.8 - 1 g/kg/d |
| Post-op 1-1.5 g/kg/d |
| Infxn 1.5 - 2.5 g/kg/d |
| Severe sepsis 2.5 g/kg/d |
| Fat |
| Start low 20% 125mL (250 kcal) |
| Most people need 20% 250mL (500kcal) |
| CHF want minimal volume so may do |
| More fat so (500mL: 1000kcal) |
| NOTE: diprovan has fat (10mL/hr = 250kcal a day) |
| Dextrose |
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| This depends on how many calories are still needed |
| After AA and Fats calculated. |
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| Think about how much fluid is okay (CHF?) |
| Are they getting IVPB or maintenance D5? |
| Average is D20% |
| Electrolytes (this is standard) |
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| mEq or mM / Liter |
| NaCl 35 mEq (20-50 is typical range) CHF? |
| Na acetate 29.5 mEq (converts to HCO3) |
| KCl 20 mEq |
| Calcium 4.5 mEq (gluconate) |
| Mg 5 mEq (sulfate) |
| KPhosphate 10-15 mM (unless RF) |
| Always do Trace Elements, Multivitamins |
| Insulin |
| Add 5 U/L in non-DM |
| In DM match Dextrose conc with Insulin Units |
| D20 - use 20 Units regular insulin |
| And have insulin SS ordered |
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