Nutritional Requirements

For repletion of energy reserves:  I would use REE X 1.3 = 1850 X 1.3 = 2400 kcal (This is also 38 kcal/kg, 
which is also a reasonable level)

For repletion of protein:  I would use 1.8 g/kg X current weight, 64 kg.  1.8 g/kg X 64 kg = 115 g protein 
per day.

Fluid requirements:  40 cc/kg, which would be ~2560 cc per day.  This would be a starting point- He does have a fever, which will increase fluid requirements.  Normally, I would calculate 35 cc/kg (or 1.0 ml/kcal administered), but in this case, I will go with the higher estimate and adjust as needed. 
Depending upon I/O data, changes in fistula output, etc., I might need to adjust this number.  There are no 
renal issues to worry about, so we shouldn’t need to worry about fluid overload at this point- but by the 
same token, I wouldn’t want to overadminister fluid either.

Additional issues to consider:  Azulfidine, in addition to causing GI distress, is a folate antagonist- I would 
be sure to include MVI, including both vitamin B12 and folate.  Blood analysis for folate and B12 status 
might be wise before deciding whether or not to provide a replacement supplementation dose.