Gastroenterology & Nutrition | Parenteral Nutrition

Total Parenteral Nutrition (TPN) Calculator

First time users, please read the detailed instructions regarding the TPN calculator. Repeat visitors, begin by entering values in the top of the form. Age, sex, weight, and length or height are required before any calculations start. Entered values are accepted when you tab to the next field, hit "Enter" on your keyboard, or click outside the field. Values in later sections of the form are derived from values in previous sections. Many values can be customized and individually replaced. A few values, e.g. BMI or administration rates, cannot be altered unless preceding variables that determine those values are altered.

(TPN feedback to: Robert J. Rothbaum, M.D.)

Disclaimer: This interactive calculation tool was written to serve as an aid in calculating TPN. Calculations are based on the information you submit and underlying assumptions related to age, body composition, and clinical status. This calculation tool is not intended to replace thorough patient evaluation. Despite exhaustive efforts, the accuracy and completeness of the work cannot be guaranteed. Washington University and the Division of Pediatric Gastroenterology assume no responsibility for decisions made on the basis of information provided by this program.

Clear Form
Patient Name
Age	years   or   months
Sex	male   or   female
Weight	kg
Length/Height	cm
Surface Area	m2 (please do not edit Surface Area)
Body Mass Index	(please do not edit BMI) Further information about BMI

(Reset #1)
Energy Expenditures						Fluid Requirements
	kcal/day	kcal/kg/day				ml/day
Resting EE						ml/kg/day
Stressors Ventilated/Sedated (REE) No Stressors (1.3xREE) Cardiac Disorder (1.4xREE) Chronic Lung Disease - (1.4xREE) Burns (1.7xREE)						L/m2/day
	kcal/day	kcal/kg/day
Est. Total Daily EE
Infusion	12 hours 18 hours 24 hours through Peripheral IV Line Central IV Line
20% Intralipid	0 g/kg/day 0.5 g/kg/day 1 g/kg/day 1.5 g/kg/day 2 g/kg/day 2.5 g/kg/day 3 g/kg/day

(Reset #2)
Dextrose	% , mg/kg/min
Amino Acids	% , g/kg/day

(Reset #3)
Electrolytes and Minerals						Caloric Summary
	mEq/L	mEq/kg/day				(please do not edit) Kcal/day  Recommended  Total Provided = from fat + from dextrose Amino Acids:  g/kg/day
Sodium
Potassium
Chloride
Acetate
Calcium
Magnesium						Progress Note
						Energy per Day and Amino Acids per Day. Graphs draw in a
	mMol/L	mMol/kg/day
Phosphate
Administration Rates
% dextrose with % amino acids
		at ml/hr for hours/day
20% Intralipid		at ml/hr for hours/day

Supplemental Fluid	(for specific clinical situations) Select an appropriate fluid: None Lactated Ringers 1/2 NS + 20 mEq KCl/L (NG Replacement) 5% Albumin in Normal Saline other: Specify either replacement or infusion, and details: Replace every ml fluid from nasogastric tube chest tube ascitic fluid wound fistula with 1.0 0.5 ml of supplemental fluid every 4 8 12 24 hours Infuse at ml/hour for hours
Medications	Heparin 500 1000 units/L Selenium unavailable due to national shortage Other Medications to be added: List one per line. Include name, amount, units.
Vitamins and Trace Metals	standard vitamins and trace metals contact pharmacy with special requirements
Doctor's Name
Ordering	Local users (WU or BJC IP addresses) can print order sheets. Print and sign two copies of the order sheet. One copy remains with Physician Orders. The second copy is sent to the Pharmacy. Off-campus or distant users can print informational copies in the format of an order sheet. Note: If the needs of your patient are not met by these processes, then please contact the Pediatric Gastroenterology service or Robert J. Rothbaum, M.D. for additional advice and consultation.

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