Question

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Describe the approach to calculating the energy need for a patient who is septic, male, 172...

Describe the approach to calculating the energy need for a patient who is septic, male, 172 lbs, 6 feet tall, and 60 years old of age. He is able to eat orally and is not on a ventilator. He has lost approximately 10 lbs during the past 2 weeks. He is not sedated and activity is limited to sitting up and using the restroom in the ICU.

Expert Solution

SOLUTION:

To calculate energy use, more often it is estimated using formula such as Harris Benedict Equation which estimates basal metabolic rate (BMR) in Kcal/day.

weight = 172lbs= 78kg

after loss 10lbs in past two weeks his weight = 73.4 kg

Height = 6feet = 183cm

age = 60 years

Harris Benedict Equation:

BMR = 13.75 weight (kg) 5 height(cm) - 6.78 age (years) + 66

= 13.75 73.4 kg + 5 183cm - 6.78 60years + 66

= 1009.2 + 915 - 406.8 + 66

= 1990.2 - 406.8

BMR = 1986.1 Kcal /day.

The Energy need for this patient for every day is 1986.1 Kcal/day.

There should maintain the balance of macronutrients ( proteins, lipid, carbohydrate) and micronutrients ( vitamins, minerals) needs provide in small amounts.

Protein should give in the range of 1.2 - 2.0 g/kg/day for ICU patients.

lipids should provide 40% of his requirements then 1986.1 0.4 = 794.4 Kcal of lipid

carbohydrates of remaining content of requirements should provide.

person is in ICU then glucose control is necessary to maintain target values. the target of glucose levels is

4.4- 6.1mmol/L and treatment generally starts if glucose levels climbs above 8.3.

Nightingale answered 1 year ago

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