Enteral Nutrition Calculator

Tube feeding analysis tool

ClinCalc.com » Nutrition » Enteral Nutrition Calculator

Patient Parameters

Gender	Male Female
Height	in cm
Body weight	kg lbs
Fluid restriction	None Moderate Severe
Propofol	mcg/kg/min

Formulation

Diabetisource AC Fibersource HN Glucerna (1.0 Cal) Glucerna (1.2 Cal) Glucerna (1.5 Cal) Glytrol Impact Impact Glutamine Impact Peptide 1.5 Impact with Fiber Isosource 1.5 Isosource HN Jevity (1 Cal) Jevity (1.2 Cal) Jevity (1.5 Cal) Kate Farms Peptide 1.5 Liquid Hope Nepro with Carb Steady Novasource Renal Nutren 1.0 Nutren 1.0 Fiber Nutren 1.5 Nutren 2.0 Nutren Pulmonary Nutrihep Osmolite (1 Cal) Osmolite (1.2 Cal) Osmolite (1.5 Cal) Oxepa Peptamen Peptamen 1.5 Peptamen 1.5 with PreBio Peptamen AF Peptamen Bariatric Peptamen with PreBio Perative Pivot (1.5 Cal) Promote Promote with Fiber Pulmocare Renalcal Replete Replete Fiber Suplena with Carb Steady TwoCal HN Vital (1.0 Cal) Vital (1.5 Cal) Vital AF (1.2 Cal) Vital HN Vital HP Vivonex Plus Vivonex RTF Vivonex TEN
Goal kcal/kg
Total protein/kg
Feed duration	24 hrs 22 hrs 20 hrs 18 hrs 16 hrs 12 hrs 8 hrs
Protein packet	gm/packet

About This Calculator

This calculator is not appropriate for the following patient populations, or may require a higher degree of clinical judgment:

Determining Caloric Requirements

The ESPEN guidelines for critical care suggest a maximum caloric intake of 20-25 kcal/kg/day during the acute and initial phase of critical illness, but 25-30 kcal/kg/day during the anabolic recovery phase.² Certain patients (eg, malnourished or morbidly obese) may have different caloric requirements than the standard patient.

Selecting an Appropriate Formulation

The selection of the appropriate tube feed formulation is a very patient-specific decision. The following factors may play a role in choosing a formulation:

• Macronutrient complexity - Polymeric, semi-elemental, or elemental preparations are available depending on the patient's ability to break down, absorb, and tolerate macronutrients.
• Protein content - Some formulas contain a particularly high content of protein, which is often more appropriate for patients in the acute stages of critical illness.
• Volume - Fluid-restricted formulas with a higher caloric density (kcal/mL) are available, but may cause more problems with diarrhea due to high osmolality.
• Disease-specific formulas - Some products are designed for specific disease states, such as ARDS/ALI, hepatic impairment, renal impairment, and diabetes.
• Fiber content - Particularly in patients with feeding-associated diarrhea, increasing the fiber content of a formula may improve tolerability.

For complicated patients, consider consultation with a registered dietitian for recommendations regarding appropriate enteral feeding formulas and supplements.

Considerations for Obesity

In obese patients (>20% ideal weight), this calculator uses a nutritional dosing weight.³ A nutritional dosing weight uses a correction adjustment of 25% (see equation below) to avoid underfeeding (with ideal weight) or overfeeding (with actual weight).

It should be noted that the ASPEN/SCCM guidelines recommend an alternative approach when dosing obese patients.⁴ According to these guidelines, obese patients (BMI > 30 kg/m²) should receive 11-14 kcal/kg (actual weight) or 22-25 kcal/kg (ideal weight) and protein requirements should be dosed using ideal weight (grade D).

Accuracy of Tube Feed Data

The enteral nutrition products included in this database are the more common formulations from Abbott Nutrition and Nestle Nutrition. The data used is accurate as of February 2013, but may change with time.

References and Additional Reading