Parenteral Nutrition

kcal from 400 mL of Dextrose 50%

• 50% = 50 g/100 mL → 400 mL = 200 g

• 200 g × 3.4 kcal/g = 680 kcal ✅
  Answer: 680

kcal from 300 mL of 20% IVFE

• 20% IVFE = 2 kcal/mL

• 300 mL × 2 = 600 kcal ✅
  Answer: 600

Total kcal: Dextrose 20% (500 mL) + AA 10% (250 mL)

• Dextrose: 20 g/100 mL → 500 mL = 100 g → 100 × 3.4 = 340 kcal

• AA: 10 g/100 mL → 250 mL = 25 g → 25 × 4 = 100 kcal
  Total = 340 + 100 = 440 kcal ✅
  Answer: 440

Non-protein kcal from Q3

• Non-protein = Dextrose kcal only = 340 kcal ✅
  Answer: 340

Grams of protein in 200 mL of AA 10%

• 10 g/100 mL → 200 mL = 20 g ✅
  Answer: 20 g

Protein need for 72 kg, moderate stress (1.3 g/kg)

• 72 × 1.3 = 93.6 g/day ✅
  Answer: 93.6

mOsm from 300 mL of Dextrose 70%

• 5 × (%)(mL) → 5 × 70 × 300 = 105,000 mOsm ✅
  Answer: 105,000

Osmolarity from AA 8.5% (250 mL) + Dextrose 50% (350 mL)

• Dextrose: 5 × 50 × 350 = 87,500

• AA: 10 × 8.5 × 250 = 21,250

• Total: 87,500 + 21,250 = 108,750 mOsm → 108,750 / 1000 mL = 109 mOsm/L ✅
  Answer: 109

GIR (Glucose Infusion Rate)

Formula:
GIR = (mg/day) / (1440 × kg)
= (300,000 mg) / (1440 × 75)
= 300,000 / 108,000 = 2.78 → 2.8 mg/kg/min ✅
Answer: 2.8

Max IVFE rate (60 kg, 20% IVFE, 500 mL)

• Max fat = 0.11 g/kg/hr → 60 × 0.11 = 6.6 g/hr

• 20% = 0.2 g/mL → Max rate = 6.6 / 0.2 = 33 mL/hr ✅
  Answer: 33