Estimating Needs
These guidelines are for estimating the needs for critically ill patients
in the ICU.
Calories:
Underweight (BMI<18.5): 30-35+ kcals/kg* ABW
Normal weight (BMI 18.5-24.9): 30-35 kcals/kg* ABW
Overweight (BMI 25-29.9): 25-30-kcals/kg* ABW
Obese (BMI 30-50.0)11-14 kcals/kg ABW
BMI>50 22-25 kcals/kg (use IBW)
*Use Actual body Weight. If actual body weight is not reflective of
energy stores (hydration concerns, edema, fluid shifts) use dry weight
or usual body weight.
These are hypocaloric feedings for the obese.
Protein:
Range from 1.2-2.0 gm/kg IBW*
Some conditions may require lower levels:
Minor surgery: 1.0-1.1 gm/kg IBW*
Major Surgery: 1.2-1.5 gm /kg IBW*
Some conditions may require higher levels:
Burns: up to 2 gm pro/kg IBW*
Obesity: hypocaloric feedings may require higher levels up to 2-2.5
gm pro/kg IBW
*If a patient’s weight <IBW, use actual body weight. This will
prevent excess protein intake in patients with a low BMI.
Permissive underfeeding:
Starting point: 14 kcals/kg and 1.2 gm pro/kg
Surgery:
For calories: follow the same guidelines as noted above.
For protein: minor surgery needs are slightly less (1.0-1.1 gm /kg
IBW*)
