Patient Info
Patient Age: Gender
Patient Height ( ): Patient Weight ( ):
IBW (kg): BMI: Use:
BEE: * = kcal
Lipids (%BEE): % = Total Lipid: kcal
Amino Acids (per kg): = Total AA: g
Kcal of Proteins:
PO Diet:
Calories from IVF Rate Based?
Dextrose Solutions -
Rate: x hrs
Total ml in 24h: ml
= Total Dextrose: kcal
Propofol -
Rate: x hrs
Total ml in 24h: ml
= Total Propofol: kcal
Tube Feeds? TPN?
Tube Feeds Rate Based?
Rate: x hrs
Total ml in 24h:
kcal per ml, AA per L, Fat per L
TF Protein Cal: TF Fat Cal: Total TF Cal:
TPN
AA: (g)
Dextrose: (g)
Lipids: Volume: (ml) Frequency:
Supplements
Quantity Frequency Add Another Supplement (+)
Results
Nutrition Requirements and Formula
Oral Diet:
BEE = kcal (Using Body Weight)
Goal = BEE x = kcal
AA (/kg) = = kcal needed
Lipids = = kcal needed
Total Calorie Intake
Overall Total: kcal
Recommendations (Beta)
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