BackNutriCalculator

Calculation Method

The patient’s energy need is necessary in order to generate the optimal nutritional advice. This energy need can be entered using either formulas (5) or measurements (2). This app features more then three calculation methods. Go to the app settings to select your own set of three preferred methods.

Formulas (5):

  1. By using the formula H&B (Harris & Benedict -1984)

    In men resting metabolism amounts to (REE):

    88.362 + (13.397 x (Weight in kg)) + (4.799 x (Height in cm)) – (5.677 x Age in years))

    In women resting metabolism amounts to (REE):

    447.593 + (9.247 x (Weight in kg)) + (3.098 x (Height in cm)) – (4.33 x Age in years))

    If the H&B formula is selected, it is possible to alter the standard supplement setting (activities/illness) for the actual calculation. The standard setting (=+30%) can be altered in the Settings for the Harris & Benedict Supplement. The available supplements will be: -30%, -25%, -20%, -15% -10%, -5%, 0%, +5%, +10%, +15%, +20%, +25%, +30%, +35%, +40%, +45%, +50%.

    The H&B energy need is expressed as kcal/day: TEE (Total Energy Expenditure) = REE + supplement

  2. By using formula WHO (1985)

    In men resting metabolism amounts to (REE):

    18-30 year: (15.4 x Weight in kg) – (27 x Height in m) + 717
    30-60 year: (11.3 x Weight in kg) – (16 x Height in m) + 901
    >60 year: (8.8 x Weight in kg) + (1128 x Height in m) – 1071

    In women resting metabolism amounts to (REE):

    18-30 year: (13.3 x Weight in kg) + (334 x Height in m) + 35
    30-60 year: (8.7 x Weight in kg) – (25 x Height in m) + 865
    >60 year: (9.2 x Weight in kg) + (637 x Height in m) – 302

    If the WHO formula is selected, it is possible to alter the standard supplement setting (activities/illness) for the actual calculation. The standard setting (=+30%) can be altered in the Settings for the WHO Supplement. The available supplements will be: -30%, -25%, -20%, -15% -10%, -5%, 0%, +5%, +10%, +15%, +20%, +25%, +30%, +35%, +40%, +45%, +50%.

    The WHO energy need is expressed as kcal/day: TEE = REE + supplement

  3. By using formula Mifflin St. Jeor (1990)

    In men resting metabolism amounts to (REE):

    (10 x Weight in kg) + (6.25 x Height in cm) – (5 x Age in years) + 5

    In women resting metabolism amounts to (REE):

    (10 x Weight in kg) + (6.25 x Height in cm) – (5 x Age in years) – 161

    Activity factors are:

    Sedentary (little or no exercise) => activity factor = 1.2
    Light activity (light exercise/sports 1-3 days/week) => activity factor = 1.375
    Moderate activity (moderate exercise/sports 3-5 days/week) => activity factor = 1.55
    Very active (hard exercise/sports 6-7 days a week) => activity factor = 1.725
    Extra active (very hard exercise/sports and physical job) => activity factor = 1.9

    The Mifflin St. Jeor energy need is expressed as kcal/day: TEE = REE x activity factor

  4. By using formula 15-35 kcal/kg bodyweight

    By using a fixed factor e.g. 25 kcal per kg body weight the estimated energy need can be calculated. This formula is less suitable because of the estimation of the kcal amount for the associated body weight. There is a possibility to choose in a range from 15 to 35 kcal per kg bodyweight.

    The 15-35 kcal/kg energy need is expressed as kcal/day: TEE = [15...35] kcal x Weight in kg

  5. By using the formula Penn State Equation (2003/2004 & modified 2011)

    As a basis for the Penn State Equation the Mifflin St.Jeor formula is used. See 3.

    With Age >= 60 and Body Mass Index (BMI) >= 30 (= modified 2011)
    TEE = (Mifflin St.Jeor (kcal/day) x 0.71) + (Tmax x 85) + (Ve x 64) – 3085

    In other cases: (2003/2004)
    TEE = (Mifflin St.Jeor (kcal/day) x 0.96) + (Tmax x 167) + (Ve x 31) – 6212

    Tmax is the maximum body temperature in the last 24 hours in degrees Celcius.
    Ve is the minute ventilation in liters per minute at the moment of measurement by the respirator.

Measurements (2)

  1. By entering Indirect calorimetry (IC) (kcal/day)

    If Indirect Calorimetry is selected, it is possible to alter the standard supplement setting (activities/illness) for the actual calculation. The standard setting (=+10%) can be altered in the Settings for the Indirect calorimetry management supplement – where the following supplements are available: -30%, -25%, -20%, -15% -10%, -5%, 0%, +5%, +10%, +15%, +20%, +25%, +30%, +35%, +40%, +45%, +50%.

    The Indirect calorimetry energy need is expressed as kcal/day = Indirect calorimetry + supplement

  2. By entering Average VCO2 (ml/min) over 24 hours

    Avg.VCO2 energy need kcal/day (TEE) = AvgVCO2 x 8.19

    Many hospitals use a PDMS (Patient Data Management System) and an EPF (Electronic Patient File). A suitable parameter for this calculation is average VCO2 (carbon dioxide production) over 24 hours. Values for this parameter are often obtained via an interface between the ventilator and the PDMS or EPF. To obtain a more reliable value for VCO2 from the ventilator, it is important for the ventilator to be calibrated on a regular basis (e.g. every 24 hours.