7-TPN. Total Parenteral Nutrition |
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At the desktop, select 7-TPN for total parenteral nutrition calculations. Enter the Formula Frame, where the amino and dextrose, and fat formulas are specified. Strike ENTER to enter the Dose Frame, where ml per hour or per day can be specified. Strike Per Day Calcs to enter the Per Day Frame, where daily nutritional totals are shown. Strike Per Kg Calcs to view per kilogram (bodyweight) calcs.
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DESKTOP
FORMULA FRAME
Enter dextrose formula, amino formula, fat formula, dextrose to amino ratio
DOSE FRAME
Enter m/hr or ml/day for dextrose amino formula and fat formula
PER DAY FRAME
View nutritional values for protein, carbohydrate, and fat, in grams/day and kcal/day
PER KG FRAME view nutritional values for protein, carbohydrate, and fat, in grams per kilogram bodyweight per day and kilocalories per kilogram bodyweight per day
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TPN: formula frame |
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The formula frame allows the selection of dextrose formula, amino acid formula, fat formula, and percentage dextro:amino mix. The nutritional values for each of these formulas can be found in the appendix.
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A. Enter Dextrose formula: D5W, D10W, D20W, D50W, or D70W.
B. Enter Amino formula, 5.5%,8.5%,or 10%.
C. Enter Fat formula, 10% or 20%. NOTE. If no fat is being given, set the value to 10%.
D. Adjust the (DEX:AA) dextrose to amino ratio if necessary by toggling the +dex or +AA (amino) keys. Each toggle changes the ratio by 10%.
E.Strike Enter when completed.
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TPN: dose frame |
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The dose frame allows the entry of dose per hour or per day for dextrose formula, amino acid formula and fat formula.
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A & A1. Enter dose of Amino plus dextrose formula. Strike either AA+D in the Ml/hr column (CCQ) or AA+D in the ML/day column. The default value is 100 ml/hr = 2400 ml/day. This can be changed as needed.
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B. Enter fat formula dose in ml/hr or ml/day. If no fat is given, this should be set to zero.
C. The total (AA+D)+fat TPN dose is calculated per hour and per day.
D. Fluid requirement is shown for reference. This is copied from the nutritional requirements in the BEE/IBW.
E. When the correct dosages are entered, strike Per day calcs.
F. Alternately, strike per kg (really per kg per day) calculations.
G. Alternately return to the formula frame by striking Formulas.
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TPN: per day calculations |
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The per day frame shows TPN calculations on a gram per day and kcal per day basis.
Strike Per day calcs from the TPN dose frame.
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Read
A. Protein delivered gm/d
B. Protein delivered Kcal/d
C. Carbohydrate (CHO) gm/d
D. CHO kcal/d (also known as "nonprotein kilocalories")
E. Fat gm/d
F. Fat Kcal/d
G. Total kilocalories per day
H. Protein required g/d (copied from BEE)
I. Adjusted BEE (ABEE) in kcal/d (copied from BEE).
J. Nitrogen required g/d
from BEE/IBW.
K. Strike Per kg calcs to go to the per kg frame.
L. Strike TPN dose calcs to return to the dose frame.
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Working backward from the per day frame: |
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It is possible to work backward from a desired value for Total kcal/day or of Non-protein kcal/day to compute the desired dose in ml/day and kcal/day. This permits the clinician to fine-tune the TPN delivery to meet specified goals.
To work backward from Total kcal/d, 1. Tap Total kcal/d.
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2. Enter desired kcal/day. Example: 2000 kcal/day.
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3. View the TPN dose frame. The dose of AA+D has been adjusted to 60 ml/hr = 1443 ml/day. Fat is not changed by working backward. Strike Per day calcs.
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All per day values are recomputed based on the new dose. Total kcal/d is now 2000 kcal/d, as desired.
Non-protein kcal/d (NPKcal) can also be selected at the per day frame, and the dose will be reset to match this delivery.
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NOTE: The TPN formulas can be changed by selecting Formula at the dose frame. It may be necessary to change formulas or formula proportions to arrive at a satisfactory combination of kcal and ml/day.
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TPN: per kg frame |
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The per kg frame shows TPN calculations per kilogram actual body weight, per day.
Strike Per kg calcs from the TPN dose frame.
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Read
A. Protein delivered gm/kg (actual bodyweight)/day
B. Protein delivered Kcal/kg/d
C. Carbohydrate (CHO) gm/kg/d
D. CHO kcal/kg/d (also known as "nonprotein kilocalories per kilogram bodyweight")
E. Fat gm/kg/d
F. Fat Kcal/kg/d
G. Total kilocalories per kg per day
H. Actual weight in kg, copied from BEE/IBW data frame. NOTE: if another weight reference is desired, for example, ideal bodyweight, strike Wt kg and enter the desired reference weight. All per kilogram vaues will be computed based on this reference weight
I. Adjusted BEE (ABEE) in kcal/kg/d (copied from BEE).
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You may work backward from Total Kcal/kg/d (G) or from NP (nonprotein kilocalories per kg per day (D). Strike either key and enter the desired value. The dose in ml/hr and ml/day will be recomputed so that the desired total kilocalorids per kg per day or nonprotein kilocalories per kg per day matches the desired figure. See previous page for a further discussion of working backward.
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