Propofol
1.1 cal per CC (can cause weight gain and increased TG)
Dextrose calories
3.4 kcal/mL
so if 4% in 1500 mL
1500 x .04 x 3.4 = 204 kcal
Open system EN
Feeding prepared on site; empty cans into the feeding bag (higher contamination risk w/ a 4hr hang time)
Closed system EN
- purchased ready to serve
- hang time is 24-48hrs
Dilantin med will loose
Phenobarbital
W/ Phenobarbital loss will be (5)
- Vita K
- Vita D
- Vita B6
- Vita B12
- Folate
Gastric residual volume (GFV)
- the volume of fluid removing in the stomach at a point in time during EN
- should be checked 4-8 hours
- 250 mL or less (give a promotility agent)
- If over over 500 mL, HOLD TF, pt might have poor tolerance
PPN vs TPN
PPN: Given through surface veins 800-900
TPN: Given through subclavian (risk of bacterial translocation)
PPN Indications
- Post surgery
- Mild to moderate malnutrition
- Supplement to EN
Refeeding Syndrome (3 things that lower)
Associated w/ low K, Mg, Ph
* everything lowers (even glucose)
PN Fat
10% = ___ Kcal/mL
20% = ____ kcal/mL
- 1 kcal/mL
2. 0 kcal/mL
Access for EN (3)
- Nasogastric (best mimics normal eating)
- Nasodudonal/Nasojejunal = for those that can’t have gastric feedings
- Nasojejunal = to prevent aspiration (farthest from the gastric region)
Access longer than 3-4 weeks EN (2)
- PEG = adv. dysphagia
2. PEJ = can’t tolerate PEG
Total PN Indicators (TPN)
Can’t absorb nutrients for more than 7 to 14 days
3 types of EN
- Isotonic (300 mOsm)
- Pre-digested/elemental (for like acute pancreatitis)
- Specialized like Nepro
Cyclic Feedings
- Delivered by continuous drip at an increased rate over 8-12hrs, often overnight or by pump
Intermittent feeding
EN is delivered via boluses or gravity for 20-60 mins every 4-6 hrs
Glucose Infusion Rate for Carbohydrate Load
CHO (in grams) x 1000 / Weight (kg) / 1440 (mins in a day)
mg/kg/min
Free Water
- 1cal/cc
- 1.5cal/cc
- 2.0cal/cc
- 1cal/cc: 83%
- 1.5cal/cc: 77%
- 2.0cal/cc: 70%
