Hogeschool van Amsterdam

Urban Vitality

An algorithm for balanced protein/energy provision in critically ill mechanically ventilated patients

Summary: BACKGROUNDS & AIMS Optimal nutritional therapy for energy and protein in critically ill, mechanically ventilated patients can be defined as: providing calories matched with the measured energy expenditure and delivery of protein in an amount of 1.2–1.5 g/kg pre-admission weight/day. Several enteral nutritional products are available with different energy/protein proportions. We developed an algorithm to choose the nutritional formula that combines optimal energy and protein supply for individual patients.


The energy and protein values of three nutritional formulas were used together with an aimed provision of 1.2–1.5 g protein/kg/day to construct a nomogram. From that, an algorithm followed, which was tested retrospectively in 203 mechanically ventilated patients with a normal BMI and known values for energy expenditure and weight.


In the nomogram cut-off points for energy/weight ratios were: 19.0–23.8 for a normal energy/high protein formula, 23.8–29.8 for a high energy/high protein formula and 30–37.5 for the normal energy/normal protein formula. The algorithm uses energy expenditure/body weight ratio of the patients to choose one of the three formulas. This resulted in an adequate provision of protein in 93% of the patients.


The algorithm leads to provision of adequate amounts of protein and energy in the majority of critically ill, mechanically ventilated patients.


Strack van Schijndel, R. J., Weijs, P. J., Sauerwein, H. P., de Groot, S. D., Beishuizen, A., & Girbes, A. R. (2007). An algorithm for balanced protein/energy provision in critically ill mechanically ventilated patients. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, 2(4), 69-74.

Gepubliceerd door  Kenniscentrum Bewegen, Sport en Voeding 7 juni 2007


jun 2007