nutrition

Question 1

baseline nutritional requirement (in kcal/kg/d)?

Answer 1

20-25 kcal/kg/d

Protein—20% of caloric intake (4 kcal/g); requirement 1 g/kg/d
Fat—30% of caloric intake (9 kcal/g)
Carbohydrate—50% of caloric intake (4 kcal/g)

Question 2

% or kcal/kg/d increase in kcal needed per day in response to surgery/trauma/sepsis

Answer 2

20-40%

25-30kcal/kg/d

Question 3

nutritional requirements after burn?

kcal/kg/d and protein

Answer 3

Calories: 25 kcal/kg/d + (30 kcal/d × % burn)

Protein: 1 g/kg/d + (3 g/d × % burn)

Question 4

Predicted increase in caloric requirements as a function of a stressor?

elective surgery? multisystem trauma? sepsis? burns?

Answer 4

Elective surgery: 1.2 times higher

Multisystem trauma: 1.3 to 1.5 times higher

Sepsis: 1.5 to 1.8 times higher

Burns: 1.5 to 2.0 times higher

Question 5

goal glucose after surgery

Answer 5

140-180 mg/dL

Question 6

elyte changes with refeeding syndrome?

Answer 6

hypophosphatemic
hypokalemic
hypomagnesemic

due to insulin release
avoid by slow introduction of nutrition

Question 7

equation for nitrogen balance?

Answer 7

Nitrogen balance = (protein intake ÷ 6.25) – (UUN + 4)

6.25 g of protein contain 1 g of nitrogen

UUN = 24-hour urine urea nitrogen

“4” is an estimate of stool and insensible losses

positive balance means protein requirements are being met

Question 8

RQ value of fat utilization

Answer 8

0.7

Question 9

RQ value of protein utilization

Answer 9

0.8

Question 10

RQ value of carbohydrate utilization

Answer 10

1.0

Question 11

RQ value of starving and ketosis

Answer 11

<0.7

Question 12

RQ value of overfeeding and excess carbohydrates

Answer 12

1.0

Question 13

markers for long term nutrition

Answer 13

albumin t1/2 = 20d

transferrin t1/2 = 10d

Question 14

markers for shrot term nutrition

Answer 14

pre-albumin t1/2 = 2d

retinol-binding protein t1/2=12hr