Ch 2: Energy Flashcards
APSEN guidelines state that the goal intake for all classes of obesity should not exceed ___% of target energy expenditure as measured by IC?
65-75%
Which predictive equation has been shown to be valid in both healthy men and women (including those with higher BMI then the original sample)?
The Mifflin St Jeor equation
Which predictive equation is recommended by AND for use in the adult critically ill patient?
The Penn State Equation
The PSE appears to be accurate in most morbidly obese patients, patients with brain injuries, and patients in barbiturate coma. Accuracy rate is lower in patients with a low BMI and in patients with cystic fibrosis.
Per ASPEN guidelines, what are the recommended protein requirements for for patients with BMI 30-40?
Greater or equal to 2.0 gm/kg IBW/day
In the low nutrition risk patient, how long should PN be withheld following ICU admission when patient can not maintain volitional intake?
7 days
Per ASPEN guidelines, what are the recommended calorie requirements for patients with a BMI > 50?
22-25 kcal/kg IBW
Per ASPEN guidelines, what are the recommended energy and protein requirements for normal weight critically ill patients?
Use public predicative equation or simplistic weight-based 25 to 30 kcals/ kg using dry BW or UBW in critically ill pts.
Protein: 1.2 - 2.0 g/kg actual BW per day
What are the contraindications to using indirect calorimetry?
ECMO, HD, Reliance on supplemental oxygen, inability to cooperate with measurement, claustrophobia or anxiety about measurement, FIO2 of >60% (for mechanically ventilated patients)
In healthy individuals, the HBE tends to _____ resting metabolic rate
Overestimate
When should PN be supplemented in a normal risk critically ill patient?
After 7-10 days of EN, if unable to meet > 60% of estimated needs
Per ASPEN guidelines, what are the recommended protein requirements for for patients with BMI > 40?
Up to 2.5 g/kg IBW/day
In healthy obese individuals, which predictive equation is the most accurate?
The Mifflin St Jeor equation
Per ASPEN guidelines, what are the recommended calorie requirements for patients with a BMI 30-50?
11-14 kcal/kg actual body weight per day (not to exceed 65-75% of target energy requirements as measured by IC).
What % of energy needs should be provided within the first 48-72 hours of admission for a critically ill patient?
80% of estimated protein/energy needs in the first 48-72 hours
When should PN be initiated for a critically ill high risk/malnourished patient?
On admit when EN is not feasible
