Which is more accurate and preferred in calculation of maintenance doses of different electrolytes in ICU patients (adults or pediatrics) who receive TPN is using the IBW (ideal body weight) or the actual weight?
The actual weight but you need to think about edema if present and the disease that caused him to be in the ICU to recalculate anything.
The actual body weight for sure, during the times I worked in the hospital we used to use the actual body weight but taking into consideration if there is edema, ascites, any metabolic disorder which forces us to use pre-edema weight according to information provided by the a contious patient or by a family member that knows, but in cases we dont have pre-edema weight we will use the Ideal body weight after placing the patient in the ICU on a bed that measures his weight, based on our percise calculations we will prepare his diet wether enterally or parenterally.
Hope my answer helps
it is true what you said for sure, in case of ascites drainage must be done so electrolyte balance becomes better, and in case of edema proper medication must be provided to releave the case. but until these processes are done which takes time and we cant leave the patient that much without proper nutrition so IBW is used.
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