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Clinical Data Input Body Surface Area Outpatient Tools Ideal Body Weight Resting Energy Expenditure OutpatientNotes Inpatient Tools Inpatient Energy Estimation Inpatient Protein Estimation Fluid Requirement Calculation TPN Calculator References
Clinical Data

Derived Data
Current BMI: (*)
Estimated ambulatory energy expenditure (kcal):
Inpatient energy target (kcal):

Body Surface Area
Body Surface Area, m2
Dubois & Dubois0.007184 * W0.425 * H0.725
Furquan & Haque([4 * W + 7] / [90 + W])
Gehan & George0.0235 * W0.51456 * H0.42246
Haycock0.024265 * W0.5378 * H0.3964
Livingston & Lee0.1173 * W0.6466
Mosteller√ [W * H / 3600]
W = weight, kg H = height, cm
Oupatient Tools
Ideal Body Weight
SourceIBW(lb)IBW(kg)BMI(kg/m²)
Devine
Robinson
Miller
Hamwi
MetLife 1999
(small frame)
MetLife 1999
(med frame)
MetLife 1999
(large frame)
Ideal Body Weight Formulae
FormulaWomenMen
Devine100 lb + 5 lb per inch over 5'110 lb + 5 lb per inch over 5'
45.5 kg + 2.3 kg per inch over 5'50 kg+ 2.3 kg per inch over 5'
Robinson
Reference
107.8 lb + 3.7 lb per inch over 5'114.4 lb + 4.2 lb per inch over 5'
49 kg+ 1.7 kg per inch over 5'52 kg + 1.9 kg per inch over 5'
Miller116.8 lb + 3.0 lb per inch over 5'123.6 lb + 3.1 lb per inch over 5'
53.1 kg + 1.36 kg per inch over 5'56.2 kg + 1.41 kg per inch over 5'
Hamwi100.1 lb + 4.8 lb per inch over 5'105.6 lb + 4.9 lb per inch over 5'
45.5 kg + 2.2 kg per inch over 5'48.0 kg + 2.7 kg per inch over 5'
MetropolitanThese values have been arrived at by performing a linear regression on the data from the 1999 Metropolitan Life Tables (available here).
The derived slopes and intercepts are detailed here.
Metropolitan data assumes indoor clothing weighing 5 pounds for men and 3 pounds for women, shoes with 1-inch heels for both sexes.
Frame Size Determination - Women
Medium Frame Size
HeightElbow breadthHeightWrist circumference
4'10" - 5'3" 2 1/4" - 2 1/2" less than 5'2" 5 1/2" - 5 3/4"
5'4" - 5'11" 2 3/8" - 2 5/8" 5'2" - 5'5" 6" - 6 1/4"
6'0" or greater 2 1/2 " - 2 3/4" greater than 5'5" 6 1/4" - 6 1/2"
Frame Size Determination - Men
Medium Frame Size
HeightElbow breadthHeightWrist circumference
5'2" - 5'3" 2 1/2" - 2 7/8" 5'5" or less Use female chart
5'4" - 5'7" 2 5/8" - 2 7/8"
5'8" - 5'11" 2 3/4" - 3" 5'6" or greater 6 1/2" - 7 1/2"
6'0" - 6'3" 2 3/4" - 3 1/8"
6'4" or greater 2 7/8" - 3 1/4"
Resting Energy Expenditure, kcal
Harris-BenedictM: 66.473 + 5.003 * H(cm) + 13.752 * W(kg) - 6.755 * Age(yr)
F: 655.096 + 1.850 * H(cm) + 9.563 * W(kg) - 4.676 * Age(yr)
Reference
Mifflin-St JeorM: 5 + 6.25 * H(cm) + 10 * W(kg) - 5 * Age(yr)
F: -161 + 6.25 * H(cm) + 10 * W(kg) - 5 * Age(yr)
Reference
Physical Activity Multiplier
Lifestyle DescriptionMultiplierChoose
Inactive (e.g., bed rest)1.2
Sedentary or light activity lifestyle1.40 - 1.69
Active or moderately active lifestyle1.70 - 1.99
Vigorous or vigorously active lifestyle2.00 - 2.40

Description of physical activity levels

Estimated Energy Requirement
EEE goes here
Outpatient Notes
The BMI (or Quetelet Index) is calculated as: BMI = 703 * Weight(lb) ÷ [Height(in)]2
Standard BMI weight status categories for adults are:(*)
BMIWeight Status
Below 18.5Underweight
18.5 - 24.9Normal
25.0 - 29.9Overweight
Above 29.9Obese
Metropolitan Tables
(midpoint weight from 1999 Metropolitan table range) = height(in) * Slope + Intercept
Sex/Frame SizeSlopeInterceptR-value
Female/Small2.82-59.360.9954
Female/Medium2.95-52.730.9994
Female/Large3.25-65.150.9986
Male/Small2.66-36.140.9879
Male/Medium3.07-56.460.9916
Male/Large3.54-78.080.9934
Examples of Activity Levels (*)
Sedentary or light activity lifestyles. These people have occupations that do not demand much physical effort, are not required to walk long distances, generally use motor vehicles for transportation, do not exercise or participate in sports regularly, and spend most of their leisure time sitting or standing, with little body displacement (e.g. talking, reading, watching television, listening to the radio, using computers). One example is male office workers in urban areas, who only occasionally engage in physically demanding activities during or outside working hours. Another example are rural women living in villages that have electricity, piped water and nearby paved roads, who spend most of the time selling produce at home or in the marketplace, or doing light household chores and caring for children in or around their houses.
Active or moderately active lifestyles. These people have occupations that are not strenuous in terms of energy demands, but involve more energy expenditure than that described for sedentary lifestyles. Alternatively, they can be people with sedentary occupations who regularly spend a certain amount of time in moderate to vigorous physical activities, during either the obligatory or the discretionary part of their daily routine. For example, the daily performance of one hour (either continuous or in several bouts during the day) of moderate to vigorous exercise, such as jogging/running, cycling, aerobic dancing or various sports activities, can raise a person's average PAL from 1.55 (corresponding to the sedentary category) to 1.75 (the moderately active category). Other examples of moderately active lifestyles are associated with occupations such as masons and construction workers, or rural women in less developed traditional villages who participate in agricultural chores or walk long distances to fetch water and fuelwood.
Vigorous or vigorously active lifestyles. These people engage regularly in strenuous work or in strenuous leisure activities for several hours. Examples are women with non-sedentary occupations who swim or dance an average of two hours each day, or non-mechanized agricultural labourers who work with a machete, hoe or axe for several hours daily and walk long distances over rugged terrains, often carrying heavy loads.
Inpatient Tools
Estimated Energy Requirement in Hospitalized Patients
Selected caloric target (kcal/24h):
xxxx
Estimation based on body weight
SourcePatient
characteristics
MultiplierPredicted Energy
Requirement, kcal
Select
Ziegler Critically ill patients25 hi
ASPENnonobese25 - 30 hi
BMI 30 - 5011 - 14 hi
BMI > 5022 - 25 * IBW hi
Estimation based on REE multipliers
SourcePatient
characteristics
MultiplierPredicted Energy
Requirement, kcal
Select
MilesAll hospitalized patients
without burns, head injuries or fever
1.0 - 1.2 hi
Head trauma1.2 - 1.45 xxxx - xxxx
Burns > 45% BSA1.4 - 1.5 xxxx - xxxx
ZieglerCritically ill patients 1.0 - 1.2 hi
BarakInfectionxxxxxxxxx - xxxx
Liver diseasexxxxx xxxx - xxxx
IBDxxxxx xxxx - xxxx
Abscessxxxxx xxxx - xxxx
Pancreatic diseasexxxxx xxxx - xxxx
Solid tumor 1.0 - 1.2 hi
Other infectionsxxxxx xxxx - xxxx
Transplantationxxxxx xxxx - xxxx
General Surgeryxxxxx xxxx - xxxx
Leukemia/lymphomaxxxxx xxxx - xxxx
Sepsisxxxxx xxxx - xxxx
Burnsxxxxx xxxx - xxxx
rd411.comPredicted EE = BMR * Activity Factor * Stress Factor + T° Factor
Activity Factor xxxx - xxxx🡄

🡄
Comatose 1.1
Confined to bed 1.2
Confined to chair 1.25
Out of bed 1.3
Ambulatory 1.5
Stress Factor
Surgery
Minor 1.0-1.2
Major 1.1-1.3
Skeletal trauma 1.1-1.6
Head trauma 1.6-1.8
Pressure Ulcers
Stage I 1.0-1.1
Stage II 1.2
Stage III 1.3-1.4
Stage IV 1.5-1.6
Infection
Mild 1.0-1.2
Moderate 1.2-1.4
Severe 1.4-1.8
Burns
< 20% BSA 1.2-1.5
20%-40% BSA 1.5-1.8
Estimated Protein Requirement in Hospitalized Patients
Selected protein target (g/24h):
xxx
SourcePatient
characteristics
MultiplierPredicted Protein
Requirement, g/24h
Select
Ziegler Normal renal & hepatic function1.2-1.5 hi
Hepatic failure (cholestasis)0.6-1.2 hi
Encephalopathy0.6 hi
Acute renal failure,
not on replacement therapy
0.6-1.0 hi
Renal failure,
on replacement therapy
1.2-1.5 hi
Stein Normal metabolism0.8 hi
Non-hypercatabolic,
polyuric recovery from ARF
1.0-1.3 hi
Severe acute
pancreatitis
1.2-1.5 hi
1.5 g/kg/day may be exceeded in extremely catabolic, critically ill patients depending on their energy requirements.
An intake of up to 2.5 g/kg body weight/day is recommended by some authors in order to achieve a positive nitrogen balance, particularly in burns patients with no kidney or liver insufficiency, as well as in critically ill patients requiring dialysis due to renal insufficiency
An adjustment of the protein intake to >1.5 g/kg body weight/day is also recommended in malnourished patients
ESPEN Acute renal failure
Conservative therapy
Mild catabolism
0.6-0.8 hi
Acute renal failure
Extracorporeal therapy
Moderate catabolism
1.0-1.5 hi
Acute renal failure
Continuous replacement therapy
Severe hypercatabolism
1.7 hi
Alcoholic steatohepatitis
Hepatic cirrhosis
1.2-1.5 hi
Acute liver failure0.8-1.2 hi
Aspen
2016
Non-obese1.2 - 2.0 hi
BMI 30 - 402.0 * IBW hi
BMI 40 - 502.0 - 2.5 * IBW hi
BMI > 502.5 * IBW hi
Continuous renal
replacement therapy
2.5 hi
Burns1.5 - 2 hi
For open abdomen, add 15 - 30 g/liter of lost exudate
Fluid Requirement Calculation
Holliday-Segar methodcc H2O/24h
Body Surface Area methodcc H2O/24h
Holliday-Segar method
Fluid requirements are calculated by the Holliday-Segar method as follows: (*)
WeightFluid requirement/24h
0 - 10 kg100 ml/kg
10 - 20 kg1000 ml + 50 ml/kg for every kg over 10 kg
> 20 kg1500 ml + 20 ml/kg for every kg over 20 kg
Body Surface Area method
Fluid requirement/24h = 1500 ml/m2 (BSA by method of Mosteller)
TPN Calculator
Choose components and parameters
Choose CHO source Target kcal/24h
Choose Lipid source
% nonprotein kcal as lipid
Choose Protein source Target protein, g/day:
Estimated fluid requirement, cc/day
AA, cc/day Dextrose, cc/day Lipids, cc/day Total volume, cc/day**** Volume excess/deficit, cc/day****
Protein kcal CHO kcal : Lipid kcal : Non-lipid infusion rate, cc/hr
AA, final conc**.* Dextrose, final conc**.* Lipid load, g/kg/d*.* Nonprotein kcal*** Nonprotein kcal :
g N ratio
***
Glucose load, g/kg/hr*.**
References
  1. Barak N, Wall-Alonso E, Sitrin MD. Evaluation of stress factors and body weight adjustments currently used to estimate energy expenditure in hospitalized patients. J. Parenter Enteral Nutr, 26:231-238, 2002
  2. Blue Cross Blue Shield of Tennessee. "Height and Weight Tables." n.d. <http://www.bcbst.com/MPManual/HW.htm>
  3. Centers for Disease Control and Prevention. "About Adult BMI." 27 July 2009. <http://www.cdc.gov/healthyweight/assessing/bmi/adult_BMI/index.html>
  4. National Heart, Lung and Blood Institute. "Standard BMI Calculator" n.d. <http://nhblisupport/bmi/bmicalc.htm>
  5. DuBois D; DuBois EF: A formula to estimate the approximate surface area if height and weight be known. Arch Int Med 1916 17:863-71.
  6. ESPEN Guidelines for adult parenteral nutrition. Clinical Nutrition 2009; 28:359-479
  7. Food and Agriculture Organization of the United Nations. "Human Energy Requirements" October 2001. <ftp://ftp.fao.org/docrep/fao/007/y5686e/y5686e00.pdf>
  8. Furqan M, Haque A. Surface Area In Children: A Simple Formula. Indian Pediatr 2009;46: 1085-1087. <http://indianpediatrics.net/dec2009/dec-1085-1087.htm>
  9. Gehan EA, George SL, Estimation of human body surface area from height and weight. Cancer Chemother Rep 1970 54:225-35.
  10. Harris JA, Benedict FG. A biometric study of basal metabolism in man. Washington, DC: Carnegie Institute of Washington, Publication no 279, 1919.
  11. Haycock G.B., Schwartz G.J.,Wisotsky D.H. Geometric method for measuring body surface area: A height weight formula validated in infants, children and adults. The Journal of Pediatrics 1978 93:1:62-66
  12. Holliday, MA, Segar, WE. 1957. The maintenance need for water in parenteral fluid therapy. Pediatrics 19:823-832.
  13. Livingston, EH, Lee S. Body surface area prediction in normal-weight and obese patients. Am J Physiol Endocrinol Metab 281:E586-E591, 2001. <http://ajpendo.physiology.org/content/281/3/E586.long>
  14. McClave SA Taylor BE, Martindale RG et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient. Journal of Parenteral and Enteral Nutrition 2016 40(2):159–211 <https://aspenjournals.onlinelibrary.wiley.com/doi/full/10.1177/0148607115621863>
  15. Mifflin MD, St Jeor ST, Hill LA, Scott BJ, Daugherty SA, Koh YO. A new predictive equation for resting energy expenditure in healthy individuals. Am J Clin Nutr 1990;51:241-7. <http://www.ajcn.org/content/51/2/241.full.pdf>
  16. Miles JM: Energy Expenditure in Hospitalized Patients: Implications for Nutritional Support. Mayo Clin Proc 2006; Jun 81(6):809-16 <http://www.mayoclinicproceedings.com/content/81/6/809.long>
  17. Mosteller RD: Simplified Calculation of Body Surface Area. N Engl J Med 1987 Oct 22;317(17):1098 <http://www.nejm.org/doi/full/10.1056/NEJM198710223171717>
  18. RD411.com. "Energy Requirement for Adults" November 2010. <http://www.rd411.com/index.php?option=com_content&view=article&id=97>
  19. Robinson JD, Lupkiewicz SM, Palenik L, Lopez LM, Ariet M. Determination of ideal body weight for drug dosage calculations. Am J Hosp Pharm 1983 40:1016-9.
  20. Stein J, Boehles HJ, Blumenstein I, Goeters C, Schulz R. Amino acids - Guidelines on Parenteral Nutrition, Chapter 4. GMS Ger Med Sci 2009;7:Doc24 <http://www.egms.de/static/en/journals/gms/2009-7/000083.shtml>
  21. Ziegler TR. Parenteral Nutrition in the Critically Ill Patient. N Engl J Med 2009; 361:1088-1097 <http://www.nejm.org/doi/full/10.1056/NEJMct0806956>