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Nutrition in Clinical Practice
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Nutrition Requirements of a Severely Stressed Obese Patient: A Case Study

Neeta Pahwa, MS, RD, CNSD

St Luke's Episcopal Hospital, Texas Heart Institute, and Baylor College of Medicine and University of Texas, Houston

Ann-Marie Hedberg, DrPH, RD

St Luke's Episcopal Hospital, Texas Heart Institute, and Baylor College of Medicine and University of Texas, Houston

Branislav Radovancevic, MD

St Luke's Episcopal Hospital, Texas Heart Institute, and Baylor College of Medicine and University of Texas, Houston

Surendra Jain, MD, FACC

St Luke's Episcopal Hospital, Texas Heart Institute, and Baylor College of Medicine and University of Texas, Houston

This case illustrates that a highly stressed obese patient has a higher basal energy expenditure than a normal-weight individual. Prealbumin levels were used as an index of response to nutrition support. It was readily determined that much greater levels of calories and protein were necessary to produce anabolism, as demonstrated by prealbumin response and wound granulation, than would have been estimated using conventional methods. Conventional methods used are the Harris-Benedict formula with stress and activity factor, kcal/kg, body weight, nitrogen balance studies, and using adjusted weight to calculate needs for obese patients.

Nutrition in Clinical Practice, Vol. 12, No. 4, 155-157 (1997)
DOI: 10.1177/088453369701200403
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