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TERAPI NUTRISI PADA PASIEN CARDIAC CACHEXIA ET CAUSA CHRONIC HEART FAILURE NYHA III DENGAN PENYULIT EDEMA PARU KARDIOGENIK AKUT Layle Rahmiyanti; Suryani As’ad; Nurbaya Syam
IJCNP : INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN Vol 3 No 1 (2020): IJCNP (INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN)
Publisher : Perhimpunan Dokter Gizi Klinik Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54773/ijcnp.v3i1.21

Abstract

Pendahuluan Cardiac cachexia (CC) adalah penurunan berat badan dengan/ tanpa muscle wasting pada pasien gagal jantung. Terapi nutrisi merupakan salah satu upaya untuk mencegah perburukan klinis CC. Laporan Kasus Ny.R, 54 tahun dikonsultasikan dengan diagnosa edema paru kardiogenik akut dan congestive heart failure NYHA III. Keluhan utama berupa masukan makan berkurang sejak 1 tahun dan memberat dalam 8 hari terakhir karena sesak napas. Ada riwayat penurunan berat badan, namun tidak diketahui besar penurunannya. Tampak lemah dan sesak napas. Antropometri: TB 154 cm, LLA 19.5 cm. Terdapat kehilangan jaringan lemak subkutan dan muscle wasting tanpa edema. Handgrip strength 5.2 kg. Food recall 24 hour 343 kkal. Status gizi buruk berdasarkan SGA. Terapi nutrisi: kalori 1600 kkal diberikan bertahap, dengan komposisi makronutrien: karbohidrat 45-50%, protein 1.5 gr/kgBBI/hari dan lemak 32-37%. Diberikan nutrient spesifik berupa EPA dan BCAA. Suplementasi mikronutrien: zink, curcuma, vitamin Bkompleks, thiamin dan ekstrak ikan gabus. Setelah Pasien dipulangkan, kami lakukan pemantauan selama 8 bulan untuk menilai asupan kalori, berat badan dan kapasitas fungsional serta kepatuhan pasien terhadap program terapi nutrisi yang diberikan. Terdapat perbaikan klinis peningkatan asupan energi, berat badan yang stabil, dan peningkatan kapasitas fungsional. Kesimpulan Terapi nutrisi yang adekuat dan pemberian nutrient spesifik dapat mencegah perburukan CC.
Nutritional Therapy in High Output Enterocutaneus Fistula with Ileum Adhesion Grade III-IV : A Case Report January, Rima; Agussalim Bukhari; Nurbaya Syam; Nurpudji Astuti Taslim; Suryani As’ad; Haerani Rasyid; A. Yasmin Syauki
Nusantara Medical Science Journal Volume 9 Issue 1, January - June 2024
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.vi.26614

Abstract

Introduction and importance: Enterocutaneus fistula (ECF) is an uncommon connection between the gastrointestinal tract and the skin. Loss of intestinal fluid in ECF patients results in an imbalance of electrolytes. The objectives of nutritional therapy were to fulfill nutrient needs, maintain fluid balance, & promote ECF closure.  Presentation of case:    A 22-year-old male, was diagnosed with post-adhesiolysis and end colostomy surgery. His oral intake was reduced for one month, and he experienced weight loss. We detected a loss of subcutaneous fat and fistula in the right abdomen region and wasted time on physical examination. Abnormal laboratory findings were leucocytosis, thrombocytosis, imbalance electrolyte, and hypoalbuminemia.  Discussion: Nutritional assessment was based on mid-upper arm circumference. Nutritional treatment was provided with a calorie target of 2300 kcal and protein 2g/kg ideal body weight (IBW)/day. On the seventh day of treatment, the patient went through relaparotomy due to high output ECF (2000 ml/d) and ileum adhesion grade 3-4. Following surgery, the patient was on parenteral nutrition for eighteen days. Due to high ECF output, protein intake was increased by 2g/kg IBW/day, and fluid intake was adjusted based on fistula output. The patient received a combination of polymeric formula and whey protein by oral intake and micronutrient supplementation at twice the usual dosage. By the 27th day of treatment, ECF output had decreased to 0 ml/d, and laboratory results showed improvement. Conclusions:   Adequate nutrition, fluid, and electrolyte balance through optimal nutritional therapy can improve laboratory values and reduce ECF output in ECF patients
Nutritional Therapy in Adult Hirschsprung Disease Post-Total Colectomy and Ileostomy with Severe Protein-Energy Malnutrition: A Case Report Faradilah, Andi; Christine Rogahang; Nurbaya Syam; Agussalim Bukhari
Alami Journal (Alauddin Islamic Medical) Journal Vol 9 No 2 (2025): JULY
Publisher : Universitas Islam Negeri Alauddin Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24252/alami.v9i2.60167

Abstract

Adult Hirschsprung disease, also known as congenital aganglionic megacolon, is a rare congenital disorder characterized by the absence of ganglion cells in the distal segment of the large intestine, diagnosed in adulthood. Impaired nutrient absorption due to the dysfunctional intestinal segment can lead to malabsorption and malnutrition. A 23-year-old female presented with severe protein-energy malnutrition after total colectomy surgery for suspected adult Hirschsprung disease. She had a history of chronic constipation from childhood, abdominal pain, and abdominal distension. She was referred to a clinical nutritionist 2 days post-surgery. The nutrition therapy started with oral and parenteral nutrition, gradually increasing macronutrient requirements based on clinical condition and gastrointestinal tolerance.  On the 12th day post-total colectomy surgery, she developed complications of obstructive ileus, requiring ileostomy. Laboratory tests showed signs of inflammation. Nutritional support for adult Hirschsprung disease focuses on meeting energy requirements, enhancing nutrient absorption after abdominal surgery, and minimizing post-operative inflammation.