Sample TPN Calculation:

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Sample TPN Calculation
60 yo male with small bowel resection 510 (178
cm), 140 (63.6 kg)
1. Estimate daily energy needs 35 kcal/kg x
63.6 kg 2230 kcal/day
2. Estimate daily protein needs 1.5 g/ kg
x 63.6 kg 95 kg or 95 g/ 6.25
15.3 g Nitrogen
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3. Estimate Fluid Needs 30 mL fluid/ kg x
63.6 kg 1910 mL
4. Based on these data, assume a final volume of
2,000 mL or 2 L will be used. Assume lt10 of
total volume will be used for additives.
5. Two more assumptions 25 of kcal from
fat Standard solutions 20 lipid, D70W, 10 AA
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Lipids Calculation 2230 kcal/ day X 0.25 (25
of kcal) 560 lipid kcals
560 lipid kcals X 1 mL/ 2 kcal (20 lipid
emulsion) 280 mL/ day or 140 mL in each
liter
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Calculate Amino Acids 95 g protein/ day X
100 mL/ 10 g AA 950 mL 10 AA or 475 mL
per liter
Options Can either count or NOT count protein
kcals in total. In either case, must KNOW how
much will be delivered to prevent UNDER- or
OVER-feeding.
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If we assume we will NOT include protein
kcals 75 of kcals will be met from DEXTROSE.
2230 total kcals X 0.75 1675 kcals from
dextrose 1675 dextrose kcals X 1 gram/ 3.4
kcal/gram 495 grams dextrose/day
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Volume of D70W needed 495
grams dextrose X 100 mL / 70 g 710 mL
70 D/ day or 355 mL/ L of TPN solution
Based on above Each liter contains-- 140 mL
20 lipid emulsion 475 mL 10 AA
solution 355 mL 70 dextrose 30-70 mL
additives
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Use this info to calculate FINAL of
nutrients Lipids
140 mL/ liter X 20 g lipid/ 100 mL X 1 L/ 1000 mL
0.028 g lipids/ mL X 100 mL 2.8 lipids
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Amino Acid
475 mL / liter X 10 grams AA / 100 mL X 1 L /
1000 mL 0.0475 g AA/ mL X 100 4.75 amino
acids
Dextrose
355 mL/ liter X 70 g dextrose / 100 mL X 1 L
/ 1000 mL 0.2485 g dextrose/ mL X 100
24.85 AA
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Summary and TPN Order Total
Volume 2,000 mL / 24 hrs 83 ml/
hr. Nonprotein energy 2235 kcal (25 lipid, 75
dextrose) Protein 95 grams Kcal N
ratio 2235 nonprotein kcal/ 15.3 g N
146 1
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Sample TPN Order 2 L/ day of 25 dextrose, 2.8
lipid emulsion, and 4.75 amino acid solution
with STD additives to run at 83 cc/hr.
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Monitoring Guidelines