Enteral (or parenteral) feeding regimens should be specific to each patient following a nutritional assessment. Dietitians estimate nutritional requirements using Prediction Equations (Basal Metabolic Rate Studies in Humans: Measurement and Development of New Equations, C.J. Henry 2005). Prediction equations take into account the patient’s:
- Weight in kilogrammes.
- Gender.
- Age.
- Stress factors which reflect the patient’s physical condition and their need to gain or lose weight.
- The patient’s current activity level (e.g. bedbound or mobile).
This tool is used to provide guidelines for determining the nutritional requirements of adults receiving nutritional support. It is used as a baseline for estimating the person’s requirements and will be adjusted as necessary by the responsible dietitian. The catabolic phase is associated with the need for high energy requirements, which needs to be balanced against the risk of overfeeding as this leads to poorer outcomes. This increased energy requirement can persist for several weeks or months.
The Brain Trauma Foundation 2007 recommends that protein should provide 15-20% of calories. (Ref to follow)