IT Quiz Answer – Jun 27, 2024

Alfred is an ICU patient whose daily nutritional needs are 1650–1800 calories and 71–92 grams of protein. He is currently receiving propofol at a rate of 15.6 mL / hr. Using a standard tube feeding formula with a calorie density of 1.5 kcal / mL, calculate Alfred’s goal continuous tube feeding rate.

1. 30 mL / hr
2. 35 mL / hr
3. 40 mL / hr
4. 45 mL / hr 

Answer: The first step here is to calculate how many calories Alfred is receiving from propofol, which provides 1.1 kcal per mL. A propofol rate of 15.6 mL / hr x 24 hours x 1.1 kcal / mL would provide 411 calories per day. To figure out Alfred’s adjusted calorie goals on propofol, we will subtract 411 calories from the upper end of his caloric needs (i.e., 1800 calories). 1800 kcals – 411 kcals = 1389 kcals. To find the goal continuous rate for this patient, divide 1389 calories by 24 hours and then by the formula’s calorie density of 1.5 kcal / mL, which gives a rate of 38.5 mL / hr. Since tube feeding rates are ordered as multiples of five, we can round down to 35 mL / hr or up to 40 mL / hr. A rate of 35 mL / hr plus propofol provides 1671 kcal (35 mL / hr x 1.5 kcal / mL x 24 hours = 1260 kcal + 411 kcal from propofol = 1671 total kcal). A rate of 40 mL / hr plus propofol provides 1851 kcal (40 mL / hr x 1.5 kcal / mL x 24 hours = 1440 kcal + 411 kcal from propofol = 1851 total kcal), which exceeds the patient’s calorie goals by 51 kcals. Therefore, the correct answer is a rate of 35 mL / hr, as 30 mL / hr would fall short of Alfred’s calorie goals and 45 mL / hr would exceed them.