CONFIDENTIAL

O.A. Tatucu-Babet and E.J. Ridley

2
How much underfeeding can the critically ill adult patient tolerate, Journal of Intensive Medicine 2 (2022) 69–77
 CONFIDENTIAL
Nutrition therapy in critical illness

Annual revenue
growth

van Zanten, A.R.H., De Waele, E. & Wischmeyer, P.E. Nutrition therapy and critical illness:
practical guidance for the ICU, post-ICU, and long-term convalescence phases. Crit Care 23, 368 (2019)
 CONFIDENTIAL
KAEN 3B Hospital Diet PROTEN Gold BFLUID KAEN 3B

TNM For Sepsis/ Critical ill

BW 40 kg; TEE 1900 kcal
Calorie req. 10 – 20 kcal/kgBW adv. by 33% every day D1: 10 – 20 kcal = 400 – 800 kcal
Protein req. 1 – 1.5 g/kgBW/day = 60 – 90 g/day D2: 13 – 26 kcal = 520 – 1040 kcal
Energy 108 kcal/L Energy 235 kcal
CHO req. 45 – 60% total calorie D3: 17 – 35 kcal = 680 – 1400 kcal Protein 10 gr
Energy 420 kcal/L
Na 50 mEq/L AA 30 gr/L
Fat req. 25 – 35% total calorie K 20 mEq/L Fat 7.5 gr BCAA 9 gr/L
Cl 50 mEq/L MCT 2 gr Glucose 75 gr/L
Glucose 27 gr Omega-3 0.6 gr Vit. B1 1.5 mg/L
2500 Omega-6 2.9 gr
Zn 5 umol
- - - - - Calorie Target
2000 100% TEE
210 210
470 470
1500 ↑ P 30 gr
75% 470 470
33% 420
l
Resuscitation 50% kca
1000 1 0-20 420 P 20 gr
w
Sta rt l o 54
470
1400 1400
25% 210 1200 1200
470 P 45 gr
500
235
P 10 gr 235 600 P 20 gr

200 300 300

0
Day 1 Inpatient Day 2 Day 3 Day 4 Day 5 Day 6 Day 1 Outpatient Day 2
Based on ESPEN Guideline*
Disclaimer: The information provided is intended for educational benefit only.
Nutritional needs may vary in each patient cases Health care professional should use their independent judgement when reviewing educational resources.
 CONFIDENTIAL
Oral Diet PROTEN Gold BFLUID
TNM For Critically ill
Start hypocaloric nutrition
BW 50 kg; TEE 1850 kcal
Calorie req. 35 – 40 kcal/kgBW/day = 1750 – 2000 kcal/day
Protein req. 1.2 – 2 g/kgBW/day = 60 – 100 g/day Energy 235 kcal
CHO 45 – 65% total calorie Omega-3 0.6 gr
Fat 25 – 35% total calorie Energy 420 kcal/L
Omega-6 2.9 gr Glucose 75 gr/L
Protein 10 gr Vit. B1 1.5 mg/L
Fat 7.5 gr
- - - - - Calorie Target MCT 2 gr
BCAA 9 gr/L
AA 30 gr/L
2500
Zn 5 umol

100%
210
2000
420 705 706
420 470
60-70% 75
1500
TEE % 470
50 210 470
%
1000
470
210
25 1500 1500 1500
% 235 1200
500 1000
210 700
500
235
0 0
Day 1 Acute Day 2 Acute Day 3 Acute Day 4 Post Acute Day 5 Post Acute Day 6 Post ICU Day 7 Day 8

Based on ESPEN Guideline*

Disclaimer: The information provided is intended for educational benefit only.
Nutritional needs may vary in each patient cases Health care professional should use their independent judgement when reviewing educational resources.
 CONFIDENTIAL
Case Report: ♀ 55 , BB 52kg th

a 55-year old female is involved in a high-speed motor vehicle

accident and admitted to intensive care from the emergency
department for ventilator support. She has several high rib
fractures with associated major lung contusion and a
haemothorax that has been drained. She also has a fractured
left humerus, left femur and collapsed pelvis. She has no
cerebral injury. There are no abdominal signs and a computed
tomography (CT) scan could not demonstrate any major intra-
abdominal injury

O.A. Tatucu-Babet and E.J. Ridley

6
How much underfeeding can the critically ill adult patient tolerate, Journal of Intensive Medicine 2 (2022) 69–77
 CONFIDENTIAL

O.A. Tatucu-Babet and E.J. Ridley

7
How much underfeeding can the critically ill adult patient tolerate, Journal of Intensive Medicine 2 (2022) 69–77