Question

In emergency care unite, TPN prescribed to a patient weight 88kg. He needs the following macronutrient: 500 cc of 10% lipid fat – 48 g of protein using 10% amino acid solution and D70.

A) Calculate the total osmolality of the TPN.

B) How many grams of fat will be used?

Answer 1

A.CALCULATION OF THE TOTAL OSMOLARITY OF THE TPN:

OSMOLARITY:

The concentration of a solution expressed as the total number of solute particles per litre.

Osmolarity is also refers to the concentration of dissolved particles of chemicals and minerals such as sodium and other electrolytes in serum.

Blood osmolarity is measured in milliosmoles per kilogram. A normal result is typically 275 to 295millimoles per kilogram. The exact standards for normal may vary, depending on doctor and lab.

TO CALCULATE OSMOLARITY SOLUTION IN TPN CLINT:

1. Multiply grams of dextrose per liter by 5.

2. Multiply grams of protein per liter by 10.

3. Add 1&2

4.add 300 to 400 to the answer from "C".( Vitamins and minerals contribute about 300 to 400mosm/L).

HERE: Dextrose is D70, 10%Aminoacid.

1L D70W(700g Dex/L)

1L 10%AA(100gAA/L)

700g×5=3500 mosm

100g×10=1000 mosm

3500+1000=4500

4500+300 to 400=4800 to 4900mosm/L.

This is the osmolarity of the solution...

B.TOTAL GRAMS OF LIPID FATS USED:

Since lipid emulsions contain glycerol, the lipid emulsion does not have 9 kcal per gram.as it would if it were pure fat. To determine kcalories supplied by lipid,..

Multiply the volume of 10%lipid (in ml) by 1.1

Multiply the volume of 20%lipid ( in ml) by 2.0.

500 ml of 10% lipid

500ml × 1.1kcal/ ml=550kcal.

550kcal=712.78grams of lipid fat.