BEE-IBW |
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Use BEE/IBW to calculate Basal Entergy Expenditure, Ideal Body Weight, BMI,and related clinical references
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BEE/IBW calculations
BEE—Basal Energy Expenditure (Harris/Benedict)
— Adjusted BEE, with activity factor, injury factor, and gain or loss
— IBW- Ideal Body Weight,
—-Met Life IBW
— BMI -Body Mass Index
— Fluid Requirement
— Protein Requirement
— Nitrogen Requirement
— Weight Change
To select BEE/IBW, strike the BEE-IBW icon with the stylus.
Note: you must be in the applications desktop. If you are not, strike the “APPLICATIONS” key.
The BEE-IBW icon may not be in the same location as shown. The exact location depends on what other programs you have on the Palm PDA.
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BEE/IBW overview |
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From the desktop, enter the BEE/IBW data frame. From there, go to bodyweight, weight change, or nutritional requirements
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DESKTOP
DATA FRAME
Enter height, weight, age, sex, frame size
BODYWEIGHT FRAME
View IBW, Met Life Hi and Low, IBW%, BMI
WT CHANGE FRAME
Enter prev wt, prev wt date. View weight change, severity flag
NUTRITIONAL REQS FRAME
View BEE, Adjusted BEE, Protein Req., Fluid Req,
ABEE FRAME
Adjust BEE for Activity Factor, Injury Factor, Weight Gain or Loss Factor
PROTEIN and FLUID REQ FRAME.
Enter Protein and Fluid requirements per kilogram per day
IBW OPTIONS FRAME
Adjust for parapelegia, amputations, or manually set IBW
MANUALLY ADJUST IBW
Toggle IBW to a desired value
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BEE/IBW data frame |
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The BEE/IBW data frame allows you to enter patient information such as age, weight, height, sex, and frame size. You can use either english or metric values
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Tap Age button to enter age in years
Tap Wt lbs to enter weight in pounds
OR, Tap Wt kg to enter weight in kilograms
Tap Ht in to enter height in inches
OR, tap ht cm to enter height in centimeters
Tap Male or Female
Tap Body wt - IBW to see bodyweight frame for ideal bodyweight (IBW) calculations
Tap Weight Change to see weight change frame for weight change calculations
Tap Nutr Reqmts - BEE to see nutritional requirements frame for BEE, ABEE, and protein calculations
Tap Frame Size: Sm frame, Med frame, or Lg frame.
Tap Save to save age, weight, height, sex, and frame size
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BEE/IBW entering data |
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At the data frame enter age, weight, and height by tapping the english or metric buttons
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1. To enter age just tap the Age button.
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2. The numeric keyboard appears. Tap the digits to enter age. You may use C (clear) and CE (clear entry) as desired. When the age is correctly entered, tap OK.
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3. A. Enter weight in lbs or kg.
B. Enter height in in or cm. You can choose either the metric or English buttons. The P-21 will automatically fill in the other values.
C. Tap Male or Female.
D. Tap Small Frame, Medium Frame, or Large Frame.
NOTE: Data entry can be in any order desired. You can go back and change anything at any time.
This completes the BEE/IBW data frame. Strike SAVE to save your data (optional).
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Body weight |
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The body weight frame shows ideal body weight, Met Life range, weight high and low, IBW percent, and BMI.
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To access the body weight frame, strike Body wt at the BEE/IBW data frame.
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A. Actual weight is copied from the data frame.
B. Ideal Body Weight (IBW) is displayed in lbs and kg. IBW can be adjusted for amputations by tapping Adjusted IBW. IBW can be manually set to any value you desire by tapping Ideal Bdywt IBW.
C. Metropolitan Life high and low values are also displayed. Met Life values are based on age, sex, and frame size.
D. Weight high or low is shown. This is the difference between (A) and (B).
E. IBW% is shown, which is calculated as 100 # (B/A).
F. BMI is displayed.
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Manually adjusted Ideal Body Wt |
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IBW can be manually set to any desired value, including Met Life High, Met Life Low, or anything in between
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1. Strike Ideal Bodywt IBW at the Body weight frame.
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The warning "To recompute IBW enter ht,wt,or age" is displayed. You may at this time enter a manually computed IBW.
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Enter the new IBW based on your clinical judgment. This IBW will be used until a new IBW is recomputed. To recompute IBW from height, weight, and age, enter new values for these parameters.
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Adjusting IBW for amputations, paralysis |
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IBW can be adjusted for amputations and paralysis. Check the appropriate boxes to reflect the clinical status of the patient
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1. Select Adjusted IBW.
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2. Check pareplegic or quadriplegic if applicable. Check any amputations. Any combination of boxes can be checked Strike Enter when done.
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3. The new IBW shows adjustment for pareplegia. It is now 115.6 lbs/ 52.4 kg.
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Weight Change |
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The weight change frame calculates weight change, percent change, and whether a severe weight loss has occurred.
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1.Strike Wt Change
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2. Strike Prev wt. You may use Prev wt in kg or in lbs by striking the kg or lb button.
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3. Enter previous weight. Strike OK.
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4. Select Prev wt date.
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5. Enter month, day,and year of previous weighing. Example: 6/20/99, June 20,1999. Strike Enter.
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6. Evaluae weight change and weight change percentage for the specified time interval. If criteria are met, SEVERE WEIGHT CHANGE warning is displayed. Strike BACK to return to BEE/IBW data entry, SAVE to save dates.
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7. Entering weight interval in days. Alternatively, enter weight interval directly, in days. Strike Wt interval, and enter weight interval in days, . The correct previous weight date will be calculated from the interval given.
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Nutritional Requirements |
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The Nutritional Requirements frame calculates BEE, Adjusted BEE, Fluid Requirement and Protein Requirement, on a daily and per kilogram per day basis.
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1. At the data frame, strike Nut Req.
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2. View values:
A. Basal Energy Expenditure (BEE), based on the Harris-Benedict equation, in kcal.
B. Adjusted Basal Energy Expenditure (Adj BEE), in kcal.
C. Ireton-Jones Energy Expenditure (IJEE), kcal
D. Fluid requirements, in ml.
E. Protein requirements, in grams.
F. Nitrogen (N2) requirements, in grams.
Note that there are two columns, per day and per kg per day. Nutritional requirements are given on a per day and per kilogram (actual weight) per day basis.
3.Strike Back to return to the data frame.
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Adjusted BEE |
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Basal Energy Expenditure (BEE) may be adjusted for activity factor and injury factor, and for desired weight gain or loss
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1. Strike Adj Bee.
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A. Select activity factor, from 1.0 (inactive) to 1.5 (highly active.)
B. Select injury factor, from 1.0 (no injury) to 1.5 (severe injury).
C. Select gain or loss factor, no change, or +500 for a gain, or -500 for a desired weight loss.
Strike Enter.
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Adjusted BEE is displayed. Adjusted BEE is used as a reference in Diabetic, Renal, and TPN calculations. To save the Adjusted BEE, strike SAVE.
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Ireton-Jones Energy Expenditure (IJEE) |
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The Ireton-Jones Energy Expenditure is a useful estimate for ventilator-dependent, obese, or burn/trauma patients
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1.Strike IJEE kcal.
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2. Check as appropriate whether the patient has Obesity (wt > 130% IBW) or is or is Ventilator dependent.
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3. If the patient is ventilator dependent, check whether trauma and\or burns are present. Strike OK.
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4. View Ireton-Jones Energy Expenditure (IJEE) in kcal/day and kcal/kg/day.
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Fluid and protein requirement |
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Fluid and protein requirements on a per kg per day basis can be customized.
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1.Strike either Fluid req ml or Prot req g. (The buttons have identical function.) No adjustment is needed if the defaults (shown in per kg per day) are correct.
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2.Enter fluid/protein values:
A. Select fluid requirement in ml per kg (actual body weight) per day. (This defaults to 30 ml/kg/d.)
B. Select protein in grams per kilogram (actual or ideal—see below) per day.
The default is .8 g/kg/day, for normal (no decubitus ulcer). For Stage I through Stage IV, use values up to 1.5. Additional values up to 2.0 are also provided.
C. Check Use IBW for prot calcs to use Ideal Bodyweight (as adjusted or manually entered) for protein instead of actual weight. The default is actual weight.
Strike Enter.
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3. View fluid requirement, protein requirement, and nitrogen requirement, as adjusted above, in ml or grams per day and per kg per day.
Strike Save to retain these values for later work.
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BEE/IBW: formulas used |
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IBW = Ideal body weight
IBW = 106 + 6 * (h-60) [h > 60, males]
IBW = 106 - 2.5 * (60-h) [h < 60, males)
IBW = 100 + 5 * (h-60) [h > 60, females)
IBW = 100 - 2.5 * (60-h) [h < 60, females)
h= height, inches
Criteria for severe weight loss:
Interval wks % loss
1 >2%
4.3 >5%
13 >7.5%
24 >10%
BEE = Basal Energy Expenditure
BEE = 66+6.23W +12.7H - 6.8A (males)
BEE= 655+4.36W +4.32H - 4.7A (females)
W — actual weight in lb
H — height in inches
A — age in years
Source: Harris, J. Benedict F. (1919) Carnegie Institution.
Adjusted BEE
ABEE= BEE * AF * IF +/- GL
AF—activity factor, clinically measured, 1.0 to 1.5
IF—injury factor, clinically measured, 1.0 to 1.5
GL— gain or loss factor: +500 KCAL for gain; -500 KCAL for loss
Protein requirement - user specified (default .8 grams per kilogram actual bodyweight per day). (Modified from Posthauer, et. al. (1997) HCFA Broadcast Seminar.)
Fluid requirement = user specified (default 30 ml/kg actual bodyweight per day).
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