What caloric target is recommended in early critical illness?

ESPEN 2019 guidelines: avoid overfeeding; Days 1-3: hypocaloric feeding 70% of estimated needs acceptable (or trophic 10-20 mL/h); Days 3+: full caloric delivery 25-30 kcal/kg/day; protein 1.3-2.0 g/kg/day throughout.

Should indirect calorimetry or predictive equations be used?

Indirect calorimetry (IC) is the gold standard for energy measurement in ICU; predictive equations (Mifflin-St Jeor, Penn State, ESPEN simple equations) are acceptable when IC unavailable; all have significant error margins in critically ill patients.

When is trophic enteral nutrition appropriate?

Trophic feeding (10-20 mL/hour or 10-20 kcal/h) in early hemodynamic instability maintains gut integrity while avoiding overfeeding complications; advance to full rate over 48-72h as hemodynamics stabilize.

What protein dose is recommended in ICU patients?

Current ESPEN/ASPEN recommend 1.3-2.0 g/kg/day protein; higher doses 2.0-2.5 g/kg/day in burns (>40% TBSA) and renal replacement therapy patients; patients on CRRT lose amino acids and require higher protein replacement.

What are contraindications to early enteral nutrition in ICU?

Absolute: uncontrolled shock (high-dose vasopressors), bowel obstruction, active GI hemorrhage; relative: abdominal compartment syndrome, ileus with clinical concern, recent GI anastomosis; not contraindicated by vasopressor use alone if hemodynamics stable.

ICU Nutritional Support and Enteral Feeding Calculator

Calculates enteral nutrition goals using Mifflin-St Jeor and Penn State equations for ICU patients, protein requirements (1.2-2.0 g/kg), and ICU-specific modifications for ARDS, TBI, and post-surgical patients.

Weight

Height

Clinical Guidance

BMI is a screening measure of body size, not a direct measure of body fat. The standard WHO categories are underweight (<18.5), normal (18.5–24.9), overweight (25–29.9), and obese (≥30).

BMI can overestimate body fat in athletes with high muscle mass and underestimate it in older adults with low muscle mass. Interpret it alongside waist circumference and clinical context rather than as a standalone diagnosis.

⚕ Clinical Disclaimer: These calculators are for educational and reference purposes only. Always verify results with qualified clinical judgment and current clinical guidelines. Do not use as a sole basis for medical decisions.

How It Works

Each component has a specific meaning:

Mifflin-St Jeor — The mifflin-st jeor recorded for the patient or scenario being assessed.
Penn State equations — The penn state equations recorded for the patient or scenario being assessed.

Note: Interpret the icu nutrition result against the clinical thresholds and context described above.

How to Use

Enter the Mifflin-St Jeor, Penn State equations for the patient or scenario you are assessing. Calculates enteral nutrition goals using Mifflin-St Jeor and Penn State equations for ICU patients, protein requirements (1.2-2.0 g/kg), and ICU-specific modifications for ARDS, TBI, and post-surgical patients. Use the icu nutrition result to inform your clinical assessment.

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