TEAM C SURVIVAL GUIDE: Answer to Question #4

4.       Your patient is 3kg and she is getting D15 P30 @18cc/h, F27 @2cc/h.  How many kcal/kg/day is she getting?  What is her P, F, and GIR?  What is her total fluid?  

wt = 3kg, D15 P30 @18cc/h (360cc/d), F @ 1.1cc/h or 27cc/d

Protein (g/kg/day) = (L/d) x (g/L)
                                 Wt (kg)

30g/L x 1L/1000cc = 0.03g/cc

15 cc/h x 24 h/d = 360 cc/d

0.03g/cc x 15cc/h = 3.6g/kg/d
3kg               

Fat = cc/d x 0.2g/cc = g/kg/d
Wt

27cc/d x 0.2g/cc = 1.8g/kg/d
3kg

GIR = %glucose x cc/h = mg/kg/min
6 (constant) x wt 

15 x 15cc/h = 12.5mg/kg/min
6 x 3kg

Now calculate calories: 
Protein:

3.6g/kg/d x 4kcal/g = 14.4kcal/kg/d

Fat:

27cc/d x 2.2kcal/cc = 59.4kcal/d

Divide by 3kg = 19.8kcal/kg/d

Dextrose: 

15g/100cc x 360cc/d = 54g/d

54g/d x 3.4kcal/g = 183.6kcal/d

Divide by 3kg = 61.2 kcal/kg/d

Total Calories = Dextrose + Protein + Fat

95.4 = 61.2 + 14.4 + 19.8