Caloric needs of spinal cord injured patients during the acute and rehabilitation phases should be based on measured energy expenditure (serial indirect calorimetry measurements).  If indirect calorimetry is not available, needs can be estimated using 22.7 kcal/kg body weight for individuals with quadriplegia and 27.9 kcal/kg for those with paraplegia.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

Protein intakes of 0.8 to 2.4 grams/kg have been used without untoward effects in the acute phase of SCI. A level of 2 gm/kg is a prudent guideline for estimating protein and nitrogen needs during this phase.