For a patient with severe acute pancreatitis needing 2500 kcals/day, what is the best recommendation?

In managing a patient with severe acute pancreatitis who requires 2500 kcals per day, the selection of nutritional support is critical to providing adequate energy while minimizing stress on the pancreas.

The correct choice involves providing a formula that balances carbohydrates, proteins, and fats effectively. This approach is essential as the pancreas may struggle to manage high levels of fats or proteins, especially during an acute inflammatory episode. The use of D50W (a concentrated form of dextrose) and a lower concentration of amino acids aligns with the needs of a patient who may have impaired pancreatic function. Additionally, the inclusion of 10% lipids can help fulfill the caloric requirements while ensuring it is delivered in a controlled manner, reducing the risk of stimulating the pancreas compared to higher-fat formulas.

This formulation allows the patient to achieve their caloric goals while minimizing the risk of exacerbating their condition due to the acute stress of pancreatitis. Therefore, providing a mix of carbohydrates, proteins, and fats in a controlled intravenous manner ensures the patient gets the needed nutrients without overwhelming the pancreas.

The other options may either provide inadequate calories, inappropriate concentrations of macronutrients, or inflexible delivery methods that do not cater to the specific demands of someone with severe acute pancreatitis.