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All Journal Nusantara Medical Science Journal IJCNP (INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN)
A. Yasmin Syauki
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Health Professions Materials Science & Nanotechnology Neuroscience Public Health

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SUPLEMENTASI MIKRONUTRIEN MENUNJANG EFEKTIVITAS TERAPI GIZI PADA PASIEN AKALASIA ESOFAGUS DENGAN HIPOALBUMINEMIA BERAT St.Pasriany; Agussalim Bukhari; Haerani Rasyid; A. Yasmin Syauki
IJCNP : INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN Vol 1 No 1 (2018): 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.v1i1.24

Abstract

Pendahuluan Akalasia merupakan gangguan motilitas berupa hilangnya peristaltik esofagus dan gagalnya sfingter esofagokardia berelaksasi, makanan tertahan di esophagus. Menyebabkan malnutrisi karena asupan tidak optimal. Laporan Kasus Laki-laki 64 tahun dirawat dikonsul dengan dyspepsia e.c akalasia esofagus. Keluhan utama, asupan makan berkurang dialami sejak 2 bulan karena sulit menelan dan muntah tiap kali makan. Tidak ada nyeri menelan. Demam, batuk dan sesak tidak ada. Ada penurunan berat badan, besarnya tidak diketahui. Luka pada antebrachium dekstra et sinistra. Pasien tidak menderita diabetes maupun hipertensi. Sakit sedang, GCS E4M6V5, tanda vital normal. Status gizi severe protein energy malnutrition berdasarkan ukuran LILA (18 cm). Hasil laboratorium didapatkan deplesi berat sistem imun, hipoalbuminemia dan penurunan fungsi ginjal. Terapi nutrisi berupa diet 1430 kkal, protein 1.2g/kgBBI/hari dalam bentuk makanan cair via oral dan nutrisi parenteral. Kebutuhan cairan 1400ml/24 jam. Suplementasi vitamin B kompleks, zinc 20mg, pujimin 450mg, vitamin A 20.000IU, Vitamin C 300mg dan Curcuma 400 mg/8jam. Pemantauan asupan, toleransi saluran cerna, tanda vital dan keseimbangan cairan setiap hari. Setelah perawatan 41 hari, pasien dapat menelan makanan lunak, luka pada antebrachium menutup, tidak terjadi perburukan status gizi, albumin dan protein total meningkat. Kesimpulan Hipoalbuminemia pada pasien akalasia esofagus, efusi pleura bilateral, skin and soft tissue infection terkoreksi dengan asupan protein 1,2 gr/kgBBI/hari, Zinc 20 mg, vitamin B kompleks, Pujimin 450 mg, Vitamin A 20.000 IU, Vitamin C 300 mg dan Curcuma 400 mg/8 jam/oral.
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
Co-Authors Bukhari, Agussalim Haerani Rasyid January, Rima Nurbaya Syam Nurpudji Astuti Taslim St.Pasriany Suryani As’ad