A patient who weighs 75 kg is receiving 65 mL/hour of a 2-in-1 PN solution that contains 117 g protein and 273 g dextrose in addition to 250 mL of 20% IVFE. What is the daily caloric content of this regimen per kg body weight?

• A. 27.5 kcal/kg/day
• B. 21.9 kcal/kg/day
• C. 26.5 kcal/kg/day
• D. 25.3 kcal/kg/day

Answer: (D)

Total daily energy from a PN regimen comes from the sum of calories provided by protein, carbohydrate (dextrose), and fat. Use common caloric densities: protein 4 kcal/g, dextrose around 3.6 kcal/g, and lipid 9 kcal/g. From the regimen, 250 mL of 20% IVFE yields fat grams: 20 g per 100 mL, so 50 g fat, which provides 50 × 9 = 450 kcal.

Protein calories: 117 g × 4 kcal/g = 468 kcal.

Dextrose calories: 273 g × 3.6 kcal/g = 982.8 kcal.

Total daily calories = 468 + 982.8 + 450 = 1900.8 kcal.

Divide by body weight: 1900.8 kcal / 75 kg = 25.34 kcal/kg/day, which rounds to 25.3 kcal/kg/day.