Abstract
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.
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