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All Journal Jurnal Anestesiologi Indonesia Journal SAGO Gizi dan Kesehatan
Nadeak, Rommy Fransiscus
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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Enteral Nutrition Tolerability Assessment in Septic Shock Patients in The ICU of RSUP H. Adam Malik Medan Ansari, Aulia Kamal; Lubis, Andriamuri Primaputra; Nadeak, Rommy Fransiscus
JAI (Jurnal Anestesiologi Indonesia) Vol 16, No 3 (2024): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.58873

Abstract

Background: Enteral nutrition is recommended within 24 to 48 hours after intensive care unit (ICU) admission when resuscitation and hemodynamic stability have been achieved. This study aims to determine the tolerability of enteral nutrition in septic shock patients in the ICU. Objective: To determine the tolerability of enteral nutrition in septic shock patients in the ICU of RSUP H. Adam Malik Medan.Methods: This study is a retrospective observational study, which was conducted in the ICU of the RSUP H. Adam Malik Medan by taking patient data from January to December 2022. The samples were septic shock patients who were admitted to the ICU using mechanical ventilation and vasopressors with a length of treatment of more than 48 hours. Data was collected on the time required for enteral nutrition administration, as well as assessing patient tolerability (presence of vomiting, residuals, and incidence of ileus). Other assessments included length of stay and mortality rate.Result: This study consisted of 47 samples, with 23 male (48.9%) and 24 female (51.1%) samples. Based on the underlying disease, 40.4% of the samples were diagnosed with pneumonia. In the tolerability of enteral nutrition, 83% of the samples were tolerant of early enteral nutrition, but with a high mortality rate of 89.4%. The initiation time of enteral nutrition in patients was 4.94 ± 1.79 hours (p=0.001). The average hospital stay for sepsis patients was 7.30 ± 6.55 days (p=0.001).Conclusion: Most sepsis and septic shock patients in the ICU are tolerant of early enteral nutrition <24 hours, but it does not reduce mortality.
Hubungan rasio P(v-a)CO2/C(a-v)O2 terhadap lactate clearance sebagai penanda keberhasilan One Hour Bundle pada pasien sepsis: Pendekatan metode statistik regresi Taufik, Maulana; Nadeak, Rommy Fransiscus; Irina, Rr. Sinta; Wahyuni, Arlinda Sari
Jurnal SAGO Gizi dan Kesehatan Vol 6, No 2 (2025): Agustus
Publisher : Poltekkes Kemenkes Aceh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/gikes.v6i2.2440

Abstract

Background: A prognostic predictive value in patients with sepsis and septic shock is needed to determine the aggressiveness of the therapy we will choose. Various methods are used to predict patient mortality. Based on this, a marker is needed to assess tissue perfusion disorders.Objectives: To determine the relationship between the P(v-a)CO2/C(a-v)O2 ratio and lactate clearance as a marker of the success of the one-hour bundle in sepsis patients.Methods: This study is a descriptive analytic study of 40 patients who assessed the description of lactate, ScvO2, and PvaCO2 gap values in septic patients. The study was conducted at the Emergency Department (IGD) and Intensive Care Unit (ICU) of H. Adam Malik Hospital Medan, during the period of April to May 2023. The collected data were then analyzed using descriptive statistical methods to calculate the mean, standard deviation, and range of the variables studied. The differences between groups were analyzed using the t-test to compare the mean values of the parameters studied. Correlation analysis was conducted using Pearson’s correlation test to assess the relationship between lactate, ScvO2, and PvaCO2 gap.Results: At T0, the mean lactate level was 22,06 mmol/L (median 16,85 mmol/L), the mean P(v-a)CO2 was 9,28 mmHg (median 8,50 mmHg), and the mean P(v-a)CO2/C(a-v)O2 ratio was 3,66 (median 3,56). At T1, the mean lactate level decreased to 12,52 mmol/L (median 9,00 mmol/L), the mean P(v-a)CO2 was 8,50 mmHg (median 7,50 mmHg), and the mean P(v-a)CO2/C(a-v)O2 ratio was 3,45 (median 2,57). The average lactate clearance was 48,29%. Bivariate analysis revealed a significant relationship between lactate clearance and the P(v-a)CO2/C(a-v)O2 ratio, with a P-value of 0,009 and a Spearman correlation of -0,521, indicating a strong negative correlation between the two variables.Conclusion: There is a significant relationship between the P(v-a)CO2/C(a-v)O2 ratio and lactate clearance in the success of the one-hour bundle for sepsis patients.
Co-Authors Ansari, Aulia Kamal Irina, Rr. Sinta Lubis, Andriamuri Primaputra Taufik, Maulana Wahyuni, Arlinda Sari