Hasil Pencarian  ::  Simpan CSV :: Kembali

"Diabetics occasionally need enteral nutrition-either as supplement or in situations necessitating total dependency on enteral nutrition to fulfill their energy requirements. Enteral nutrition specifically designed fordiabet-ics is not yet available in our hospital, as sugar is often added to enteral nutrition preparations, subsequently affecting the blood glucose profiles of the patients.

This study was done to determine the glycemic index of 4 kinds of enteraf feeding formulas, conducted among ambulatory diabetics attending the Diabetic Clinic of the Dr Cipto Mangunkusumo General Central National Hospital.

Twenty samples were purposively chosen among the Diabetic Clinic attendees. They were well-controlled non-pregnant diabetics; none of them were having either kidney or liver problems, and were otherwise healthy. Each of the diabetic studied was given 50-g glucose syrup (200 Kcal) as a standard load. With a 3 to 4 days interval, the patients were consecutively given several enteral feeding formulas, i.e., the standard hospital enteral feeding formula (MC-FRS I), a newly developed diabetic formula (MC-FRS II), a frequently-used commercially avai 1-ablepredigested/elemental enteral feeding formula {MC-FK I = Isocal), and a new predigested/elemental enteral feeding formula specifically designed for diabetics (MC-FK II=Diabetasol). All of the formulas tested contained energy equal to 50-g glucose (200 Kcal). Blood glucose was measured with an Accutrend-Ames® glucometer in fasting condition and subsequently 30,60,90 and 120 minutes after the load. Any glucose/enteral feeding loading was given 30 minutes after. Data were presented as a blood glucose curve and glycemic index were calculated as area under the blood glucose curve of each food load compared to the standard glucose load, presented as percentage.

In all the enteral feedings studied, the blood glucose response curves went up and the peaks achieved in 60 minutes, thereafter declined to points above the initial fasting blood glucose values. The glycemic index of the MC-FRS I, MC-FRS II, MC-FK I and MC-FK II were 39.6%, 25%, 45% and 52.1% respectively.

The sugar that was added to the MC-FRS I and MC-FK I did not give rise to higher blood glucose levels as compared to the other non-glucose-added food. All of the enteral feeding formula tested showed low glycemic index (Miller, less than 55%). The difference glycemic index among the formulas studied might be due to different food composition (predigested/elemental component in the commercial enteral feeding formula; no sugar added and higher fiber in MC-FRS II as compared to MC-FRS I; higher fat content in MC-FK 1 as compared to MC-FK II). Glycemic index of enteral feeding formula was particularly determined by the total carbohydrate, total fat and total protein content of the food, as well as the presence of fiber and antinutrient in the food studied."

"Machine generated contents note : 1.Introduction2.Types of enteral feeding tubes3.Flushing enteral feeding tubes4.Restoring and maintaining patency of enteral feeding tubes5.Drug therapy review6.Choice of medication formulation7.The legal and professional consequences of administering drugs via enteral feeding tubes8.Health and safety and clinical risk management9.Syringes and ports10.Defining interactionsIndividual drug monographsAbacavirAcamprosate calciumAcarboseAcebutolol"

"ABSTRAKTerapi nutrisi medis merupakan salah satu intervensi untuk mengoptimalkan kontrol glikemik dan menyediakan kalori yang cukup untuk memenuhi kebutuhan metabolik. Pada pasien diabetes yang tidak dapat memenuhi kebutuhan gizinya melalui asupan makanan oral, membutuhkan enteral feeding. Penelitian ini bertujuan untukmengetahui perbandingan pemberian enteral feeding secara bolusdengan frekuensi tiga kali dan enam kali terhadap toleransi feeding dan kadarglukosa darah pada pasien diabetes melitus tipe 2. Penelitian ini adalah penelitian dengan desain quasi experimental yang melibatkan 26 orang pasien diabetesmelitus tipe 2. Hasil penelitian menunjukkan adanya perbedaan yang signifikan antara frekuensi pemberian enteral feeding sebanyak tiga kali dan enam kali terhadap toleransi feeding (p = 0.000), ada perbedaan signifikan antara frekuensi pemberian enteral feeding sebanyak tiga kali dan enam kali terhadap kadar glukosa darah (p=0.000). Hasil Penelitian ini dapat membantu pengontrolan gula darah dengan pengaturan frekuensi pemberian nutrisi pada pasien diabetes melitustipe 2.

---

ABSTRACTMedical nutrition therapy is one of the interventions to optimize glycemic controland provide adequate calories to meet metabolic needs. In diabetic patients who cannot meet their nutritional needs through oral food intake, it requires an EnteralFeeding. This study aimed to compare the three times and six timesfrequencies of bolus enteral feeding towards feeding tolerance and blood glucose levels in type 2 diabetes patients. This research was an experimental quasi-designinvolving 26 type 2 diabetes patients. The results showed that there were asignificant difference between three times and six times frequencies of bolusenteral feeding towards the feeding tolerance (p = 0.000); a significant differencebetween three times and six times the blood glucose level (p = 0.000). The results suggest that feeding tolerance and blood control sugar level can be controlled with the frequencies of the enteral feeding."

"ABSTRAKSalah satu upaya dalam mencegah terjadinya komplikasi infeksi di intensive care unit dengan memonitoring pH cairan lambung khususnya pada pasien terpasang ventilasi mekanik. Penelitian ini bertujuan mengidentifikasi perbedaan pemberian nutrisi enteral metode intermittent dan bolus feeding terhadap pH cairan lambung pasien dengan ventilasi mekanik. Penelitian ini menggunakan desain quasi experiment pada 30 responden. Kelompok pertama (15 responden) mendapatkan intervensi intermittent feeding dan kelompok kedua (15 responden) mendapatkan intervensi bolus feeding. Uji perbedaan hasil menggunakan chi-square, pooled t test dan paired t test. Hasil penelitian (between groups) menunjukkan adanya perbedaan pH cairan lambung yang bermakna pada kelompok yang mendapatkan terapi nutrisi enteral metode intermittent dan bolus feeding pada pasien dengan ventilasi mekanik (p < 0,05). Penelitian merekomendasi perawat untuk dapat melakukan tindakan pemberian nutrisi enteral dengan metode yang tepat dan berupaya menerapkan tindakan pencegahan terhadap komplikasi lebih lanjut akibat pemberian nutrisi enteral sehingga akan memperbaiki sistem layanan asuhan keperawatan.

---

ABSTRACTOne of the most common strategy to prevent infection complications in intensive care unit by monitoring pH gastric especially to patients with mechanical ventilation. The purpose of this study is to identify the difference intermittent and bolus feeding to pH gastric in patients with mechanical ventilation. The study design quacy experiment with sample of 30 respondents. First group (15 respondents) getting intermittent feeding and second group (15 respondents) getting bolus feeding. Data were analyzed using chi-square, pooled t test and paired t test. The results showed that there is a significant different of pH gastric between intermittent feeding and bolus feeding in patient with mechanical ventilation (p <0.05). Further study recommends nurses to provision enteral nutrition with right method and sought to apply complication preventive by the result of enteral nutrition."

"Latar Belakang: Studi epidemiologi menunjukkan bahwa DM merupakan salah satu faktor dalam proses terjadinya aterosklerosis dan mempengaruhi secara nyata kesaldtan dan kematian akibat PIK. Dibandingkan dengan penderita bukan DM, penderita DM 2-4 kali lebih banyak menderita P3K dan 2-4 kali lebih banyak mengalami kematian jangka pendek setelah menderita serangan infark miokard akut Dewabrata mendapati 23,2% penderita infark miokard akut yang di rawat di RSCM selama periode 1994-1999. Data di Indonesia tersebut belum banyak menggambarkan bagaimana karakteristik penderita DM tersebut saat terbukti menderita infark miokard akut. Dengan demildan, gambaran penderita DM yang mengalami sindrom koroner akut merupakan ha! yang renting untuk diketahui, baik karakteristik klinis maupun komplikasi yang muncul akibat S1CA tersebut.Tujuan. Penelitian ini ingin mengetahui prevalensi SKA pada penderita DM tipe-2. Penelitian ini juga ingin mengetahui karakteristik klinis dan komplikasi SKA pada penderita DM tipe-2 serta perbandingannya dengan penderita bukan DM. Metodologi. Studi potong lintang retrospektif untuk mengetahui prevalensi dan karakteristik klinis serta studi kohort retrospektif untuk mengetahui perbandingan komplikasi SKA pads penderita DM tipe-2 dan penderita bukan DM, terhadap penderita yang dirawat di ICCU RSCM periode 1 Januari 2001 s.d. 31 Desember 2005.Hasil. Didapatkan data: Prevalensi SKA penderita DM tipe-2: 34,2%. Awitan nyeri penderita DM lebih lama, 70,7% vs 53,4%, p=0,001; 1K 95%; DR=2,259 (1,372-3,719). Nyeri dada tidak khas, didapati penderita DM lebih banyak, 17,3% vs 9,8% p~ 0,041; 1K 95%; OR=1,713 (1,019-2,881)_ Komplikasi: Gagal jantung: penderita DM tipe-2 Iebih banyak: 39,35% vs 16,8%, p=0,001; 11(95%; RR-3,213 (1,992-5,182). Untuk komplikasi syok kardiogenik, didapati penderita DM tipe-2 Iebih banyak, 16,2% vs 8,9%, p= 0,031; IK 95%; RR==1,983 (1,057-3,721). Sedangkan komplikasi kematian didapati penderita DM tipe-2 lebih banyak, 17,3% vs 6,3%, dengan p= 0,001; 1K 95%; RR= 3,116 (1,556-6,239).Simpulan. Didapatkan perbedaan karakteristik klinis SKA antara penderita DM tipe-2 dengan penderita SKA bukan DM. Awitan nyeri lebih lama dan keluhan nyeri dada yang tidak khan, Iebih banyak didapati Dada penderita DM tipe-2. Didapatkan juga perbedaan dalam hat komplikasi SKA. Kejadian gagal jantung, syok kardiogenik dan kematian didapatkan lebih tinggi pada penderita DM tipe-2.

---

Background. Epidemiologic studies revealed diabetes mellitus (DM) as one of the factors involved in atherosclerosis process. DM also influence morbidity and mortality-related to coronary artery disease (CAD). Compared to non diabetic patients, type -2 DM patients suffer CAD 2-4 times more often and had increased short term mortality rate due to acute myocardial infarction 2-4 times more likely. During 1994-1999, Dewabrata found 23.2% of all acute myocardial infarction patients was diabetic patients treated in ICCU Cipto Mangunkusumo hospital. Unfortunately these data did not describe the clinical characteristic and complication ACS in type -2 DM patients. Therefore it is important to know the clinical characteristics and ACS related complications in type-2 DM patients.

Objectives. To know the prevalence of type-2 DM among ACS patients, to learn clinical characteristics and ACS related complications in type-2 DM compared to non diabetic patients.

Methods. A cross sectional retrospective study was performed to know the prevalence of ACS in type -2 DM patients and their clinical characteristics_ A retrospective cohort study was performed to compare the differences in ACS related complications in type -2 DM and non diabetic patients who were hospitalized in ICCU Cipto Mangunkusumo hospital during 5 years period (January 1st, 200I December 31st, 2005).

Results. Prevalence of Type-2 DM among ACS patients : 34.2%. The onset of chest pain in type-2 DM patients was longer, 70.7% vs 53.4%, p=0.40l; CI 95%; OR=2.259 (1.372-3.719). Aypical chest pain were often in type-2 DM patients, 17.3% vs 9.8%; p= 0.041; CI 95%; OR 1.713 (L019 2.881). Heart failure as complications were more often found in type-2 DM patients, 39.35% vs 16.8%, p=0.001; CI 95%; RR=3.213 (1.992-5.182), cardiogenic shock were more often found in type-2 DM patients, 16.2% vs 8.9%, p= 0.031; CI 95%; RR 1.983 (1.057-3.721), and death were more often found in type-2 DM patients, 17.3% vs 6.3%, p= 0.001; CI 95%; RR= 3.116 (L556-6.239).

Conclusions. There are differences in clinical characteristics of ACS between type-2 DM patients and non diabetic patients; which are longer onset of chestpain and atypical chestpain more often in type-2 DM patients. There are also differences in complications related ACS between Type-2 DM patients and non diabetic patients; heart failure, cardiogenic shock, and death more often in Type-2 DM patients."