Determination of the caloric requirement of patients with cancer

The weight change of 16 adult patients with cancer receiving total parenteral nutrition for an average period of 12 days was evaluated. The nitrogen to calorie ratio of the hyperalimentation fluid ranged from 1:144 to 1:235. The amount of nonprotein calories delivered was expressed as a multiple of the resting metabolic expenditure, and patients were divided according to the following different rates of calories delivered/resting metabolic expenditure into three groups: group 1, 1.11 to 1.48, mean 1.33; group 2, 1.55 to 1.76, mean 1.67, and group 3, 1.78 to 2.10, mean 1.87. The weight change in group 2 patients, +0.32 kilograms per day, was statistically different from that of group 1 patients, p less than 0.01, but not from that of group 3 patients. We conclude that the optimal hyperalimentation infusion rate to achieve weight gain in patients with cancer includes 50 nonprotein calories per kilogram per day as well as 1.5 grams of amino acids per kilogram per day with a nitrogen to calorie ratio of 1:208.