Tailoring Parenteral Nutrition | Clinical Nutrition LAM Initiative

Tailoring Parenteral Nutrition

Aiming to Meet Each Patient’s Nutritional Requirements

When it comes to disease-related malnutrition, every patient’s requirements will be different. Once parenteral nutrition (PN) is indicated, health care professionals can calculate nutrient requirements to optimize clinical nutrition therapy to the specific needs of the patient.

To meet each patient’s energy and protein requirements, it is important to consider the complete clinical picture. Energy intake during PN must be adjusted to the:1

  • Actual energy expenditure
  • Clinical situation of the patient
  • Nutritional goals based on nutritional status

Actual Energy Expenditure

Several equations are available to predict energy consumption. In clinical practice, the Harris and Benedict equation is the most commonly used to calculate resting energy expenditure (REE). Using this equation, height, body weight, gender and age are used to estimate an individual’s resting metabolic rate.2

Clinical Situation of the Patient

The patient’s clinical condition, e.g. activity or trauma factors, such as large bone fractures, sepsis, burns, severe infection, chronic renal failure and cancer, must be assessed to adjust PN. These conditions account for increased energy and protein requirements due to the physical activity and metabolic stress related to the underlying disease.

Nutritional Goals Established with Regard to Nutritional Status

When calculating a patient’s energy and protein requirements, the established objectives of the nutrition therapy must be considered, including:1

  • Provision of energy and protein to prevent body wasting during acute illness
  • Recovery of muscle and energy stores during re-convalescence
  • Catch-up growth in children
  • Nutritional status/body mass index (BMI) in severe malnutrition or cachexia

Using these parameters, carefully tailored PN can support the clinical nutrition needs of patients, thereby fighting disease-related malnutrition.

  • 1. a. b. Carpentier Y, Sobotka L. Energy. In: Sobotka L, editor. Basics in Clinical Nutrition. Prague: Galen 2011;247-251.
  • 2. Westerterp KR, Schols AMWJ, Singer P. Energy metabolism. In: Sobotka L, editor. Basics in Clinical Nutrition. Prague: Galen 2011;96-103.

Related Information

Woman in hospital bedArticleWhat is Disease-Related Malnutrition?
Professional
Nutritionist
Nurse
Pharmacist
Physician
About Disease-Related Malnutrition
Physician looking at CN productArticleWhat is Clinical Nutrition?
Professional
Nutritionist
Nurse
Pharmacist
Physician
About Clinical Nutrition
Nurse administering PN to patient in hospital bedArticleHow Is Parenteral Nutrition Applied?
Professional
Nutritionist
Nurse
Pharmacist
Physician
Handling and Administering Nutrition Therapy

Downloads

Dr. Roger Riofrio sitting in front of a United for clinical nutrition roll-up during ESPEN Congress.

Dr. Roger Riofrio

(mp4, 33.63 MB)
Dr. Dan Linetzky Waitzberg

Dr. Mario Ignacio Perman

(mp4, 64.25 MB)
Dr. Karin Papapietro sitting in front of a United for clinical nutrition roll-up during ESPEN Congress

Dr. Karin Papapietro

(mp4, 32.2 MB)