Question

Utilizing the TPN by grams method, identify the final order for a patient needing 3000 kcal and 125 grams of protein Which of the following pre-mixed TPN formulas would you select for the same patient above? Include lipid needs in you final order TPN Solution 500 cc 5.5% aa 200 cc D50W 300 cc water 500 cc 4.5% a, a 250 cc D50W 250 cc water 500 cc 4.0% aa 300 cc D40W 200 cc water 500 cc 6.0% aa 300 cc D50W 200 cc water

Answer 1

TPN stands for Total Parenteral Nutrition, defined as an IV infusion of a highly concentrated solution containing proteins, glucose, electrolytes, lipids, vitamins, and trace elements.TPN is administered into a vein, generally through a PICC (peripherally inserted central catheter) line, but can also be administered through a central line or port-a-cath.

suppose here the final order of the patient needing 3000kcal and 125 grams of proteins :

Thus we can calculate it as::

Pt receiving 3 litres consisting of:

1500 ml 50% dextrose (3.4 kcal/g)

1500 ml 8.34% CAA (4 kcal/g) {Protein in Parenteral solutions are provided in the form of crystalline amino acids (CAA)}

*CHO: is 50 g/100 ml

= x g / 1500 ml

x = 750 g dextrose x 3.4 kcal/g = 2550 kcal

*Protein:

¨1500 ml of 8.34 % amino acids:

¨ 1500 ml x 8 .34g/100 ml = 125g

¨Or 1500 x .0834 =125 g

Then kilocalorie from protein :

x= 125 x 4 = 500 = 500 kcal

Thus we can say that the total kilocalorie :

2550+ 500 = 3050 kcal,

Thus a round of 3000Kcal

*Usually a patient needs 20% of the lipid

Thus here can include the lipids in the order and then finalize the order and select:

500cc 4.0%.aa,300cc D40 W, 200cc Water