Basics of Clinical Nutrition

Question 1

How can basal (resting energy) expenditures be estimated in an uncomplicated pt?

Answer 1

Harris Benedict equation

3 Factors- weight, height, age

Question 2

What is the seldom-used Gold Standard for physically determining the resting energy expenditure for a pt?

Answer 2

Indirect calorimetry- Metabolic Card
Pt must be on ventilator
FiO2 <0.6 (60%)- useful with prolonged ventilator dependence, extreme under/over weight, advanced age, complex pts

Question 3

What are the indication for total parenteral nutrition?

Answer 3

Diffuse peritonitis
Intractable vomiting/diarrhea
Paralytic ileus
High output- enterocutaneous fistula
Complete small bowel obstruction 
Gastrointestinal ischemia
Radiation enteritis
Failure to tolerate enteral feeding

Question 4

What are the complications of total parenteral nutrition?

Answer 4

Infections
Intestinal atrophy
Bacterial translocation
Steatosis
Fatty liver
Hypertriglyceridemia
Mechanical/technical related to catheter placement
Increased costs