Caloric Requirements = Harris Benedict Eqn(a) X Injury Factor X Activity Factor
Males: 66.5 + (13.7xWt. in kg) + (5.0 x Ht. in cm) – (6.8 x age in Yrs.)
Females: 655 + (9.6 x Wt in kg) + (1.8 x Ht in cm) -(4.7 x age in Yrs.)
*Daily Basal Energy Estimate Expenditure
Injury Factors: 1.0 – Normal, Minor Surgery; 1.2 – Long Bone Fracture; 1.0-1.2 – Burn Post Graft; 1.3 – COPD, Malnourished; 1.4 – Severe Head Injury*; 1.5 – 50% Burns; 1.0-1.5 – Cancer; 1.6 – Ventilator*; 1.2-1.6 – Major Surgery, Multiple Trauma, 0-20% Burns Pre Graft; 1.2-1.7 – Acute Sepsis; 1.5-2.0 – 20-40% Burn Pre Graft; 2.0 – 50% Burn.
Activity Factor: 1.1 for each °C > 37°C.
Daily Total Energy Expenditure Estimation: Normal Maintenance: 25-28 kcal/kg; Mild-Moderate stress: 30-35 kcal/kg; Severe major stress 40 kcal/kg; Adult Burn: Maintenance + 40 kcal/% burn.
Crystalloid Fluid Resuscitation
Initial bolus:
Adults: 500 – 1000 mL & up to 30 mL/kg of NS or LRS
Maintenance infusion:
> 20 kg: 1500 mL + 20 mL/kg per kg> 20 kg/d
The fluid requirement in adults with normal hydration status is approximately 30–40 ml/kg body weight/d.
When calculating the fluid intake of parenterally fed patients, fluids supplied parenterally, orally and enterally, other infusions, and additional fluid losses (e.g. diarrhea) must be considered.
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