| |
| Maintenance |
50-60 kcal/kg/day |
| Growth |
80-90 kcal/kg/day |
|
 |
Use birthweight for calculations until it is exceeded, after which
use the actual weight. If weight increases more than 25 g/kg/day,
this may reflect fluid accumulation and the previous day's weight or a
calculated weight should be used |
|
Goal weight gain is 15-20 g/kg/day |
|
Total parenteral kcal needs are less than enteral needs. Enteral
nutrition requires energy for digestion |
|
Achievable intake depends on fluids allotted. Severe fluid restrictions
will limit the overall nutritional intake. |
|
Providing a mixed fuel system is best for energy utilization:
| Protein |
8-12% of cals |
| Carbohydrate |
40-55% of cals |
| Fat |
35-50% of cals |
|
|
|
Carbohydrates and proteins are combined in the same bag of solution
along with vitamins, minerals, electrolytes, trace elements, and other
additives. |
|
Fat is given separately and is piggybacked by a Y-connector |
|
If supplementing inadequate feeds with parenteral nutrition, the parenteral
component can be decreased with feeds tolerated at 50% goal and can be
discontinued when feeds are at 75% of goal. At that time formula
will need to be fortified to 22 kcal/ounce. |
