Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAKPada pasien sakit kritis, salah satu faktor yang berhubungan dengan angka mortalitas adalah hilangnya protein tubuh, yang digambarkan dengan imbang nitrogen negatif. Imbang nitrogen negatif merupakan akibat penyakit pasien tanpa diimbangi asupan energi dan protein yang adekuat. Berdasarkan hal tersebut, maka dilakukan penelitian ini, yang bertujuan untuk mengetahui korelasi antara asupan energi dan imbang nitrogen pasien sakit kritis di Intensive Care Unit (ICU) dewasa Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPNCM). Metode penelitian yang digunakan adalah studi potong lintang dengan cara mendapatkan sampel consecutive sampling. Kriteria penerimaan adalah pasien ICU dewasa RSUPNCM Jakarta, laki-laki atau perempuan, berusia 20-79 tahun, dan bersedia mengikuti penelitian. Kriteria penolakan adalah pasien yang mengalami gangguan fungsi ginjal atau gangguan fungsi hati. Kriteria pengeluaran adalah pasien tidak dapat mengikuti penelitian sampai selesai atau data tidak lengkap. Data penelitian meliputi asupan energi dan nitrogen, nitrogen urea urin (NUU), serta imbang nitrogen dalam 24 jam awal perawatan. Hasil penelitian menunjukkan pada 30 subyek penelitian terdapat rerata asupan energi 56,3+33,9 % berdasarkan panduan ESPEN. Rerata asupan nitrogen, NUU dan imbang nitrogen masing-masing adalah 3,8+2,7 g, 8,3+4,4 g, dan -8,5+5,5 g. Terdapat korelasi positif kuat bermakna antara asupan energi dan imbang nitrogen, r=0,6, p<0,01. Kesimpulan penelitian ini adalah semakin kurang asupan energi, maka imbang nitrogen akan semakin negatif.

---

ABSTRACTHigh protein loss is an important factor in critically ill patients mortality, that is indicated by negative nitrogen balance. Negative nitrogen balance is the result of urinary urea nitrogen (UUN), caused by the severity of the disease, compared to energy and protein intake. This study had been completed, which aimed to determine the correlation between energy intake and nitrogen balance of critically ill patients in adults Intensive Care Unit (ICU) Ciptomangunkusumo general hospital. The method of this study was a cross sectional with consecutive sampling. Inclusion criteria were patients admitted to ICU, aged 20-79 years, and agreed to join this study. Exclusion criteria were patients with kidney or liver diseases. Drop out criteria were patiens who did not complete the study or have complete data. Data collected were energy and nitrogen intake, UUN, nitrogen balance during first 24 hours. There were 30 patients who participated in this study. Energy intake mean was 56,3+33,9 %, based on ESPEN guideline. Mean of nitrogen intake, UUN, and nitrogen balance were 3,8+2,7 g, 8,3+4,4 g, and -8,5+5,5 g, respectively. The correlation between energy intake and nitrogen balance was significantly strong positive correlated. The conclusion of this study is the lower energy intake, the more negative nitrogen balance."

"[ABSTRAKPasien penyakit ginjal kronik derajat 5 mengalami suatu keadaan di mana ginjal sama sekali tidak dapat mempertahankan homeostasis metabolisme tubuh sehingga membutuhkan terapi pengganti ginjal. Terapi pengganti ginjal yang paling sering dipilih oleh pasien PGK derajat 5 adalah hemodialisis. Perubahan metabolik pada PGK derajat 5 dengan hemodialisis dapat disebabkan oleh gangguan fungsi ginjal dan proses hemodialisis. Perubahan metabolik tersebut antara lain gangguan keseimbangan cairan, dan asam basa serta gangguanmetabolisme protein, karbohidrat, dan lemak. Dibutuhkan terapi terintegrasi pada pasien PGK yang terdiri atas terapi farmakologi, terapi pengganti ginjal, terapi nutrisi dan dukungan psikologis. Peran nutrisi dalam menurunkan komplikasi dan meningkatkan kualitas hidup sangat penting dalam tatalaksana pasien PGK. Pemberian nutrisi pada pasien PGK dengan hemodialisis bertujuan untuk mengatasi gejala akibat gangguan ginjal dan mencegah komplikasi akibat progresivitas kerusakan ginjal. Pemberian nutrisi yang tepat dapat dilakukan dengan memahami patofisiologi yang terjadi pada pasien PGK dan proseshemodialisis yang dipilih sebagai terapi pengganti ginjal. Berdasarkan hal tersebut, dilaporkan empat serial kasus pada pasien PGK derajat 5 dengan hemodialisis rutin. Diberikan terapi nutrisi sesuai panduan yaitu energi 30-35 kkal per kg berat badan, protein 1,2 g per kg berat badan, lemak 25-30% energi total, dan karbohidrat 60-65% energi total. Diketahui bahwa penyebab asupan tidak terpenuhi adalah keadaan klinis yaitu sesak, penurunan kesadaran, dan gangguan saluran cerna yaitu mual dan muntah.

---

ABSTRACTStage 5 of chronic kidney disease represents total inability of kidneys to maintain body homeostasis normally. At this stage, it is necessary to use methods that substitute kidney function such as hemodialysis, peritoneal dialysis, or kidney transplantation. The most used method is hemodialysis. Metabolic changes in stage 5 of chronic kidney disease can be caused by kidney disease itself and also hemodialysis treatment. Metabolic complications of chronic kidney disease and hemodialysis include changes in acid-base balance and metabolism of proteins,carbohydrates and lipids. Patients need integrated therapy that consist of medicine, kidney function substitution, nutrition, and psychological support. Nutrition therapy is important in chronic kidney disease therapy because it can help to decrease complication and to increase quality of life. The purpose of nutrition therapy in chronic kidney disease are to overcome the symtoms and to prevent the complication that caused by kidney disease. Nutrition therapy can be done properly by understand the pathophysiologycal mechanism and the process of hemodialysis. Based on the description, four cases of stage 5 of chronic kidney disease with hemodialysis are reported here. The nutrition which is given consist of energy 30-35 kkal per kg body weight, protein 1,2 g per kg body weight, lipid 25-30 % total energy, and carbohydrate 60-65 % total energy. There is inadequacy of intake due to clinical conditions such as dispnoe, the decreased of consciousness, and intestinal disturbance like nausea and vomit. Stage 5 of chronic kidney disease represents total inability of kidneys to maintain body homeostasis normally. At this stage, it is necessary to use methods thatsubstitute kidney function such as hemodialysis, peritoneal dialysis, or kidney transplantation. The most used method is hemodialysis. Metabolic changes in stage 5 of chronic kidney disease can be caused by kidney disease itself and also hemodialysis treatment. Metabolic complications of chronic kidney disease and hemodialysis include changes in acid-base balance and metabolism of proteins, carbohydrates and lipids. Patients need integrated therapy that consist of medicine, kidney function substitution, nutrition, and psychological support. Nutrition therapy is important in chronic kidney disease therapy because it can help to decrease complication and to increase quality of life. The purpose of nutrition therapy in chronic kidney disease are to overcome the symtoms and to prevent the complication that caused by kidney disease. Nutrition therapy can be done properly by understand the pathophysiologycal mechanism and the process of hemodialysis. Based on the description, four cases of stage 5 of chronic kidney disease with hemodialysis are reported here. The nutrition which is given consist of energy 30-35 kkal per kg body weight, protein 1,2 g per kg body weight, lipid 25-30 % total energy, and carbohydrate 60-65 % total energy. There is inadequacy of intake due to clinical conditions such as dispnoe, the decreased of consciousness, and intestinal disturbance like nausea and vomit., Stage 5 of chronic kidney disease represents total inability of kidneys to maintainbody homeostasis normally. At this stage, it is necessary to use methods thatsubstitute kidney function such as hemodialysis, peritoneal dialysis, or kidneytransplantation. The most used method is hemodialysis. Metabolic changes instage 5 of chronic kidney disease can be caused by kidney disease itself and alsohemodialysis treatment. Metabolic complications of chronic kidney disease andhemodialysis include changes in acid-base balance and metabolism of proteins,carbohydrates and lipids. Patients need integrated therapy that consist of medicine, kidney function substitution, nutrition, and psychological support. Nutrition therapy is important in chronic kidney disease therapy because it can help to decrease complicationand to increase quality of life. The purpose of nutrition therapy in chronic kidney disease are toovercome the symtoms and to prevent the complication that caused by kidneydisease. Nutrition therapy can be done properly by understand thepathophysiologycal mechanism and the process of hemodialysis. Based on the description, four cases of stage 5 of chronic kidney diseasewith hemodialysis are reported here. The nutrition which is given consist ofenergy 30–35 kkal per kg body weight, protein 1,2 g per kg body weight, lipid25–30 % total energy, and carbohydrate 60–65 % total energy. There isinadequacy of intake due to clinical conditions such as dispnoe, the decreased of consciousness, and intestinal disturbance like nausea and vomit.]"