Nutrition Overview

Calories:

Dextrose- 3.4 cal/g  ||  Carbs- 4 cal/g ||  Protein- 4 cal/g   ||  Alcohol- 7 cal/g  ||       Fat- 9 cal/g

Requirements:

Calories: 20-25 cal/kg/day                                                          Protein: 1-1.5g/kg/day

TPN/PPN:

Central Line: Glucose based                                                       Peripheral Line: Fat based

Source of fuel:

Glutamine- fuel for small bowel enterocytes                          Short Chain Fatty Acids- Colonocytes

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Respiratory Quotient- Measure of energy expenditure.

CO2 expired : O2 inspired

RQ > 1= overfeeding (CO2 build up, difficulty weaning off of vent) 

RQ < 0.7= ketosis/fat utilization

Utilization

: RQ= 0.7 (fat)

RQ = 0.8 (protein)

RQ= 1 (carbs)

Balanced= 0.825

Refeeding Syndrome- Sudden shift from fat to carb metabolism hypoK/PO4/Mg

-          Decreased ATP

-          Feed at slow rate (10cal. Increase slowly)

Kwashiorkor- Protein deficiency //  Marasmus- Starvation