Hasil Pencarian  ::  Simpan CSV :: Kembali

"[Latar belakang: luka bakar akan memicu terjadinya respon inflamasi lokal dansistemik, yang dapat menimbulkan berbagai komplikasi. Pada pasien luka bakar,terjadi peningkatan kebutuhan akan zat gizi akibat kondisi hipermetabolik danhiperkatabolik yang terjadi. Tatalaksana nutrisi yang adekuat dibutuhkan untukmembantu kontrol respon inflamasi dan metabolik sehingga dapat menunjangpenyembuhan pasien. Metode: Dalam serial kasus ini terdapat empat pasien luka bakar berat yang disebabkan api dan listrik. Selama perawatan didapatkan berbagai penyulit yang mempengaruhi tatalaksana nutrisi yang diberikan. Pada pasien pertama terdapattrauma inhalasi, yang berkembang menjadi ARDS dan gagal nafas. Pada pasienkedua terdapat sepsis, yang berkembang menjadi syok sepsis dan gagal organmultipel. Pasien ketiga mengalami amputasi dan AKI, sedangkan pasien keempatmengalami rabdomiolisis, AKI, dan amputasi. Target energi dihitung berdasarkanformula Xie dan Harris Benedict, dengan target protein 1,7?2 g/kgBB, lemak 20?25% dan karbohidrat 60?65%. Nutrisi enteral dimulai dalam waktu 21?35 jampasca kejadian sebesar 13?20 kkal/kg/hari dengan metode pemberian dripintermittent. Pemberian nutrisi selanjutnya sesuaikan dengan toleransi, klinis, danpenyulit yang dialami pasien. Mikronutrien yang diberikan berupa multivitaminantioksidan, vitamin B, dan asam folat.Hasil: dua pasien pertama meninggal dalam perawatan, namun pasien pertamatelah mengalami perbaikan luas luka bakar dari 54% menjadi 32,5%. Dua pasienterakhir mengalami perbaikan kapasitas fungsional dan penyembuhan luka yangbaik. Kesimpulan: Tatalaksana nutrisi yang tepat dan adekuat sesuai dengan kondisi klinis pasien dapat menunjang penyembuhan serta menurunkan morbiditas dan mortalitas pasien.;Background: Burn injury initiates local dan systemic inflammatory reaction,resulting various complicating conditions. Nutritional requirement after majorburn significantly increased because hypermetabolic and hypercataboliccondition. Effective and adequate nutrition therapy is required to controlinflammatory dan metabolic response, therefore enchance healing process.Method: The current case series consists of four patients with severe burn injurycaused by flame and electricity. During hospitalization, complicating conditionsdeveloped in all patients which influenced nutrition therapy given to the patients.First patient had inhalation injury that developed into ARDS and respiratoryfailure, while sepsis that progress to septic shock and MODS occured in secondpatient. Third patient had amputation and AKI, while fourth patient experiencedrhabdomiolysis, AKI, and amputation. Target energy was calculated based on Xieand Harris-Benedict formula with target protein was 1,7?2 g/kgBB, lipid 20?25%,and carbohydrate 60?65%. Enteral nutrition was initiated within 21?35 hours postburn, started at 13?20 Kcal/kg/day with intermintent gravity drip method. Further,nutrition was given according to patients? tolerance, clinical condition, andcomplicating conditions. Micronutients supplementation with antioxidant, vitaminB, and folic acid were provided to all patients.Result: The first two patients died during hospitalization, however, there wasimprovement in first patient?s burn wound extent from 54% to 32,5% TBSA. Thelast two patients had satisfactory wound healing and improvement in functionalcapacity.Conclusion: Effective and adequate nutrition management inline with patient?s clinical condition lead to enhacement healing process, and reduced morbidity and mortality rate.;Background: Burn injury initiates local dan systemic inflammatory reaction,resulting various complicating conditions. Nutritional requirement after majorburn significantly increased because hypermetabolic and hypercataboliccondition. Effective and adequate nutrition therapy is required to controlinflammatory dan metabolic response, therefore enchance healing process.Method: The current case series consists of four patients with severe burn injurycaused by flame and electricity. During hospitalization, complicating conditionsdeveloped in all patients which influenced nutrition therapy given to the patients.First patient had inhalation injury that developed into ARDS and respiratoryfailure, while sepsis that progress to septic shock and MODS occured in secondpatient. Third patient had amputation and AKI, while fourth patient experiencedrhabdomiolysis, AKI, and amputation. Target energy was calculated based on Xieand Harris-Benedict formula with target protein was 1,7?2 g/kgBB, lipid 20?25%,and carbohydrate 60?65%. Enteral nutrition was initiated within 21?35 hours postburn, started at 13?20 Kcal/kg/day with intermintent gravity drip method. Further,nutrition was given according to patients? tolerance, clinical condition, andcomplicating conditions. Micronutients supplementation with antioxidant, vitaminB, and folic acid were provided to all patients.Result: The first two patients died during hospitalization, however, there wasimprovement in first patient?s burn wound extent from 54% to 32,5% TBSA. Thelast two patients had satisfactory wound healing and improvement in functionalcapacity.Conclusion: Effective and adequate nutrition management inline with patient?s clinical condition lead to enhacement healing process, and reduced morbidity and mortality rate., Background: Burn injury initiates local dan systemic inflammatory reaction,resulting various complicating conditions. Nutritional requirement after majorburn significantly increased because hypermetabolic and hypercataboliccondition. Effective and adequate nutrition therapy is required to controlinflammatory dan metabolic response, therefore enchance healing process.Method: The current case series consists of four patients with severe burn injurycaused by flame and electricity. During hospitalization, complicating conditionsdeveloped in all patients which influenced nutrition therapy given to the patients.First patient had inhalation injury that developed into ARDS and respiratoryfailure, while sepsis that progress to septic shock and MODS occured in secondpatient. Third patient had amputation and AKI, while fourth patient experiencedrhabdomiolysis, AKI, and amputation. Target energy was calculated based on Xieand Harris-Benedict formula with target protein was 1,7–2 g/kgBB, lipid 20–25%,and carbohydrate 60–65%. Enteral nutrition was initiated within 21–35 hours postburn, started at 13–20 Kcal/kg/day with intermintent gravity drip method. Further,nutrition was given according to patients’ tolerance, clinical condition, andcomplicating conditions. Micronutients supplementation with antioxidant, vitaminB, and folic acid were provided to all patients.Result: The first two patients died during hospitalization, however, there wasimprovement in first patient’s burn wound extent from 54% to 32,5% TBSA. Thelast two patients had satisfactory wound healing and improvement in functionalcapacity.Conclusion: Effective and adequate nutrition management inline with patient’s clinical condition lead to enhacement healing process, and reduced morbidity and mortality rate.]"

"[ABSTRAKSerial kasus ini bertujuan untuk mempelajari dan menerapkan terapi nutrisi sebagai bagian dari terapi tuberkulosis (TB) paru. Komplikasi yang menyertai TB paru dapat meningkatkan morbiditas dan mortalitas. Seluruh pasien serial kasus ini dalam kondisi malnutrisi dan terdapat komplikasi yang menyertai masingmasing kasus berupa drug-induced hepatotoxicity, peritonitis TB, diabetes melitus tipe 2, dan pneumotoraks dengan dispepsia. Pemberian nutrisi disesuaikan dengan kondisi, penyakit penyerta, dan kebutuhan yang bersifat individual. Kebutuhan energi basal dihitung dengan persamaan Harris-Benedict dengan kebutuhan energi total setara dengan 35?40 kkal/kg BB. Makronutrien diberikan dalam komposisi seimbang dengan protein 15?20% kebutuhan energi (1,2?1,5 g/kg BB). Saran pemberian mikronutrien minimal mencapai angka kecukupan gizi. Pasien yang mendapat obat antituberkulosis berupa isoniazid disarankan mendapat suplementasi vitamin B6 dengan dosis tertentu untuk mencegah neuritis perifer. Outcome yang dinilai meliputi kondisi klinis, asupan, dan toleransi asupan. Pemberian terapi nutrisi sebagian besar pasien dimulai dari kebutuhan energi basal yang pada akhir masa perawatan dapat mencapai target kebutuhan energi total. Pemantauan jangka panjang pasca rawat inap, disarankan tidak hanya menilai outcome berdasarkan perubahan berat badan, namun dilakukan penilaian komposisi tubuh, terutama massa lemak, karena pada kasus TB terjadi abnormalitas metabolisme yang disebut anabolic block.

---

ABSTRACTThe aim of this case series was to study and apply nutrition therapy as integral part of pulmonary tuberculosis (TB) therapy. Pulmonary TB with complications was associated with increased of morbidity and mortality. Malnutrition was coexisted with several complications such as drug-induced hepatotoxicity, peritoneal TB, type 2 diabetes mellitus, and pneumothorax with dyspepsia. HarrisBenedict equation was used to calculate basal energy requirement with total energy requirement equivalent to 35?40 kcal/body weight. Balanced macronutrient composition was given with protein 15?20% energy requirement (1,2?1,5 g/body weight). Micronutrient recommendation was given to fulfill one fold recommended daily allowance. Patients with isoniazid therapy needed to get pyridoxine supplementation to prevent peripheral neuritis. Outcome measurements included clinical condition, amount of intake, and intake tolerance. Most patients were given initial nutrition therapy from basal energy requirement and has shown increment. At the end of hospitalization, all of patients could achieve total energy requirement. Due to abnormality of metabolism, usually termed as anabolic block, it was recommended not only to measure body weight as primary outcome, but also body composition., The aim of this case series was to study and apply nutrition therapy as integral part of pulmonary tuberculosis (TB) therapy. Pulmonary TB with complications was associated with increased of morbidity and mortality. Malnutrition was coexisted with several complications such as drug-induced hepatotoxicity, peritoneal TB, type 2 diabetes mellitus, and pneumothorax with dyspepsia. HarrisBenedict equation was used to calculate basal energy requirement with total energy requirement equivalent to 35–40 kcal/body weight. Balanced macronutrient composition was given with protein 15–20% energy requirement (1,2–1,5 g/body weight). Micronutrient recommendation was given to fulfill one fold recommended daily allowance. Patients with isoniazid therapy needed to get pyridoxine supplementation to prevent peripheral neuritis. Outcome measurements included clinical condition, amount of intake, and intake tolerance. Most patients were given initial nutrition therapy from basal energy requirement and has shown increment. At the end of hospitalization, all of patients could achieve total energy requirement. Due to abnormality of metabolism, usually termed as anabolic block, it was recommended not only to measure body weight as primary outcome, but also body composition.]"

"[ABSTRAKLatar belakang: Kanker kepala dan leher merupakan salah satu keganasan yang dapat menyebabkan malnutrisi. Radioterapi dan kemoterapi merupakan bagian dari terapi pasien yang dapat menimbulkan berbagai efek samping sehingga dapat memperburuk status gizi pasien. Tujuan tatalaksana nutrisi adalahmeningkatkan asupan pasien, mempertahankan berat badan dan meminimalkan penurunan berat badan selama radiasi dan kemoterapi, meningkatkan kualitas hidup, menurunkan angka mortalitas pasien KKL pasca radioterapi dan kemoterapi. Tatalaksana nutrisi yang diberikan meliputi pemberian makronutrien, mikronutrien, nutrien spesifik serta konseling dan edukasi.Metode: Pasien pada serial kasus ini berjumlah empat orang dan berusia antara 41 hingga 57 tahun. Ketiga pasien menjalani kemoradiasi dan hanya satu pasien yang menjalani radioterapi. Hasil skrining pada semua pasien dengan menggunakan malnutrition screening tool (MST) mendapatkan nilai ≥2. Kebutuhan energi pasien dihitung dengan menggunakan rumus Harris Benedict selanjutnya dihitung kebutuhan energi total dengan faktor stres 1,5. Pemantauan yang dilakukan pada pasien meliputi keluhan subyektif, kondisi klinis, tanda vital, antropometri, kapasitas fungsional, dan analisis asupan. Monitoring dan evaluasi dilakukan secara teratur untuk memantau pencapaian target nutrisi.Hasil: Dukungan nutrisi yang diberikan pada keempat pasien dapat meningkatkan asupan dan menaikkan berat badan pasien ketiga, mempertahahankan berat badan pasien pertama dan keempat, serta meminimalkan penurunan berat badan pasien kedua. Kapasitas fungsional pasien tidak mengalami penurunan.Kesimpulan: Dukungan nutrisi yang diberikan pada pasien kanker kepala dan leher dalam terapi radiasi dapat meminimalkan, mempertahankan, dan meningkatkan berat badan, serta mempertahankan kapasitas fungsional pasien.

---

ABSTRACTIntroduction: Head and Neck Cancer is malignant disease associated with malnutrition. Radiotherapy and Chemotherapy will give side effect which can worsen nutritional status. The goal of nutritional management are to maintain or increase nutritional status, improve quality of life, and prolong survival of patients. Nutrition management include provide macronutrient, micronutrient, specific nutrients, counseling, and education. Methode: Patient in this case series were between 41 to 57 years old. Three of patients undergoing chemoradiation and one of patients on radiation therapy. All patients had a screening score ≥2 using a Malnutrition Screening Tool (MST). Nutritional status of patients were obese, normoweight with risk of malnutrition, and normoweight. Basal energy requirement were calculated using Harris Benedict Formula then calculated with stress factor 1.5 for total energy requirement. Monitoring included subjective complaints, clinical condition, vital signs, anthropometric, functional capacity and nutrition analysis. Monitoring and evaluation were done for accomplishment of nutritional targets.Results : Nutritional support could increase intake and weight gain in third patients, weight maintaining in first and fourth patients, and for second patients were minimizing weight loss. There was no decrease in functional capacity.Conclusion: Nutritional support in head and neck cancer with radiotherapy could minimizing, maintaining, and increasing body weight also maintaining functional capacity., Introduction: Head and Neck Cancer is malignant disease associated withmalnutrition. Radiotherapy and Chemotherapy will give side effect which canworsen nutritional status. The goal of nutritional management are to maintain orincrease nutritional status, improve quality of life, and prolong survival ofpatients. Nutrition management include provide macronutrient, micronutrient,specific nutrients, counseling, and education. Methode: Patient in this case series were between 41 to 57 years old. Three ofpatients undergoing chemoradiation and one of patients on radiation therapy. Allpatients had a screening score ≥2 using a Malnutrition Screening Tool (MST). Nutritional status of patients were obese, normoweight with risk of malnutrition,and normoweight. Basal energy requirement were calculated using HarrisBenedict Formula then calculated with stress factor 1.5 for total energyrequirement. Monitoring included subjective complaints, clinical condition, vitalsigns, anthropometric, functional capacity and nutrition analysis. Monitoring andevaluation were done for accomplishment of nutritional targets. Results : Nutritional support could increase intake and weight gain in thirdpatients, weight maintaining in first and fourth patients, and for second patientswere minimizing weight loss. There was no decrease in functional capacity.Conclusion: Nutritional support in head and neck cancer with radiotherapy could minimizing, maintaining, and increasing body weight also maintaining functional capacity.]"

"[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.]"

"[ABSTRAKLatar belakang: Prevalensi Diabetes Melitus Tipe (DM) tipe 2 semakin meningkat setiap tahun. Kontrol glisemik yang buruk, hipertensi, dislipidemia, dan kebiasaan merokok serta menopause dapat meningkatkan risiko komplikasi penyakit kardiovaskular. Komplikasi kardiovaskular merupakan komplikasi paling sering ditemukan dengan angka mortalitas yang tinggi. Oleh karena itu, untuk menekan progresivitas komplikasi kardiovaskular diperlukan suatu terapi nutrisi medik yang adekuat sesuai dengan kondisi klinis dan edukasi dalam memodifikasi gaya hidup.Metode: Pasien pada serial kasus berusia 55-65 tahun. Tiga pasien didiagnosis DM tipe 2 dengan gagal jantung, satu pasien dengan penyakit jantung hipertensi. Semua pasien memiliki skor skrining malnutrition screening tools (MST) ≥ 2. Dua pasien mempunyai status gizi obesitas, satu pasien berat badan dan pasien lainnya dengan berat badan normal. Kebutuhan energi basal (KEB) berdasarkan rumus Harris-Benedict dengan faktor stress 1,3-1,4 tergantung kondisi klinis dan penyakit penyerta. Komposisi makronutrien sesuai dengan rekomendasi American Diabetes Association dan Dietary Approach to Stop Hypertension. Pemberian mikronutrien dan nutrient spesifik diberikan pada satu dua kasus. Pasien dipantau selama 5-17 hari, meliputi keluhan subyektif, hemodinamik, toleransi dan analisis asupan, antropometri, pemeriksaan laboratorium, imbang cairan, dan kapasitas fungsional.Hasil: Selama pemantauan di RS, keempat pasien menunjukkan perbaikan klinis yaitu tekanan darah turun dan kapasitas fungsional membaik. Satu pasien kadar glukosa darah dipertahankan < 200 mg/dL.Kesimpulan: Terapi nutrisi medik yang adekuat dapat memperbaiki kondisi klinis pasien DM tipe 2 dengan komplikasi sistem kardiovaskular.

---

ABSTRACTBackground: The prevalence of type 2 diabetes mellitus (DM) is increasing every year. Poor glycemic control, hypertension, dyslipidemia, smooking and menopause increase the risk for cardiovascular complications. Cardiovascular complications is the most common complications in type 2 DM with a significant high mortality rate. Therefore, a medical nutrition therapy is required to decreased the progresitivity of the cardiovascular complication in DM, based on improvement of clinical conditions and lifestyle modifications.Method: Patients in this case series were between 55-65 years old. There of those patients were diagnosed heart failure and one with hypertension heart disease. All patients had a screening score ≥ 2 with malnutrition screening tools (MST). Two of patients had nutritional status of obesity, one patients was overweight, and another patients was normoweight. Basal calorie requirement were calculating using Harris-Benedict formula with stress factor 1,3-1,4 adjusment according to clinical conditions and comorbidities. Macronutriens were given recommendations by The American Diabetes Association and Dietary Approach to Stop Hypertension. Two patients received micronutrien and specific nutrients. Monitoring was done for 5-17 days included subjective complaints, hemodynamic, tolerance and intake analysis, anthropometric measurement, laboratory test, fluid balance and functional capacity.Results : All the patients showed the improvement of clinical conditions, blood control and functional capacity. Blood glucose levels of one patients was maintained to below 200 mg/dLConclusion: Medical nutrition therapy can improved clinical conditions of patients type 2 DM with cardiovascular complications., Background:The prevalence of type 2 diabetes mellitus (DM) is increasing every year. Poor glycemic control, hypertension, dyslipidemia, smooking and menopause increase the risk for cardiovascular complications. Cardiovascular complications is the most common complications in type 2 DM with a significant high mortality rate. Therefore, a medical nutrition therapy is required to decreased the progresitivity of the cardiovascular complication in DM, based on improvement of clinical conditions and lifestyle modifications.Method:Patients in this case series were between 55-65 years old. There of those patients were diagnosed heart failure and one with hypertension heart disease. All patients had a screening score ≥ 2 with malnutrition screening tools (MST). Two of patients had nutritional status of obesity, one patients was overweight, and another patients was normoweight. Basal calorie requirement were calculating using Harris-Benedict formula with stress factor 1,3-1,4 adjusment according to clinical conditions and comorbidities. Macronutriens were given recommendations by The American Diabetes Association and Dietary Approach to Stop Hypertension. Two patients received micronutrien and specific nutrients. Monitoring was done for 5-17 days included subjective complaints, hemodynamic, tolerance and intake analysis, anthropometric measurement, laboratory test, fluid balance and functional capacity.Results :All the patients showed the improvement of clinical conditions, blood control and functional capacity. Blood glucose levels of one patients was maintained to below 200 mg/dLConclusion:Medical nutrition therapy can improved clinical conditions of patients type 2 DM with cardiovascular complications.]"

"[ABSTRAK Latar belakang: Intestinal failure (IF) merupakan masalah pascabedah denganoutcome yang buruk. Saat ini telah terdapat rekomendasi terapi gizi pada IFberdasarkan etiologinya, namun belum ada laporan serial kasus yang memaparkanaplikasinya.Presentasi Kasus: Pasien dalam serial kasus ini terdiri dari 3 perempuan dan 1laki-laki, berusia 21?42 tahun. Terhadap pasien ditegakkan diagnosis IF denganberbagai etiologi, yaitu 3 pasien dengan fistula enterokutan (FEK) dan 1 pasiendengan short bowel syndrome (SBS) end jejunostomy. Terapi gizi pada pasien IFberdasarkan etiologinya. Pada pasien FEK high output, kebutuhan energi 1,5?2kali resting energy requirement (RER) atau 37?45 kkal/kg BB/hari, protein 1,5?2g/kg BB/hari. Pada FEK low output kebutuhan energi 1?1,5 kali KEB (25?30kkal/kg BB/hari), protein 1?1,5 g/kg BB/hari. Pada pasien FEK yang mendapatterapi konservatif, didapat outcome peningkatan kadar albumin serum dan beratbadan, serta produksi fistel yang berkurang. Pasien FEK dengan persiapanrekonstruksi usus halus terdapat perbaikan keadaan umum dan peningkatan kadaralbumin serum. Pada pasien SBS, terkait kondisi pascabedah maka terapi gizisesuai rekomendasi Enhanced Recovery After Surgery (ERAS), dengankebutuhan energi 25?30 kkal/kg BB/hari dengan komposisi makronutrien yangseimbang. Pada pasien ini dilakukan distal feeding dan pengaturan laju tetesankimus untuk mencegah sindrom dumping. Pasien SBS didapat outcomepeningkatan kadar albumin dan berat badan selama masa perawatan. Kesimpulan: Terapi medik gizi klinik yang adekuat memberikan outcome yang baik pada pasien IF.ABSTRACT Background: Intestinal failure (IF) is a postoperative complication with poor

outcome. Nowadays, many of nutritional management recommendations based on

etiologies of IF, but no report about those application.

Case Presentation: Three female and one male patients were included in this case

series, aged 21?42 years old. Nutritional needs in IF patients are determined by

their etiologies. IF in this case series caused by enterocutaneous fistula (ECF)

and short bowel syndrome (SBS). Nutritional needs on ECF patients depend on

their fistula production. In patients with high output ECF, energy requirement is

in 1.5?2 resting energy requirement (RER) or 37?45 kcal/kg BW/day, protein

1,5?2 g/kg BW/day. In low output ECF, energy requirement is 1?1.5 RER or 25?

30 kcal/kg BW/day hari, protein 1?1.5 g/kg BW/day. In ECF patients given

conservative therapy, serum albumin and body weight increased, while the fistula

production decreased. In patients with preoperative of intestine reconstruction

surgery, there were improvement in general condition with the increase of serum

albumin. In SBS patients, related to the postoperative condition, energy was given

according to Enhanced Recovery after Surgery (ERAS) recommendation 25?30

kkal/kg BW/day with balance of macronutrient composition. In SBS end

jejunostomy patient the food was given through distal feeding with adjusted

chymus drip to prevent dumping syndrome. There were increased in serum

albumin and body weight of the patients.

Conclusion: Adequate support medical therapy of clinical nutrition in IF patients give good outcome. , Background: Intestinal failure (IF) is a postoperative complication with poor

outcome. Nowadays, many of nutritional management recommendations based on

etiologies of IF, but no report about those application.

Case Presentation: Three female and one male patients were included in this case

series, aged 21–42 years old. Nutritional needs in IF patients are determined by

their etiologies. IF in this case series caused by enterocutaneous fistula (ECF)

and short bowel syndrome (SBS). Nutritional needs on ECF patients depend on

their fistula production. In patients with high output ECF, energy requirement is

in 1.5–2 resting energy requirement (RER) or 37–45 kcal/kg BW/day, protein

1,5–2 g/kg BW/day. In low output ECF, energy requirement is 1–1.5 RER or 25–

30 kcal/kg BW/day hari, protein 1–1.5 g/kg BW/day. In ECF patients given

conservative therapy, serum albumin and body weight increased, while the fistula

production decreased. In patients with preoperative of intestine reconstruction

surgery, there were improvement in general condition with the increase of serum

albumin. In SBS patients, related to the postoperative condition, energy was given

according to Enhanced Recovery after Surgery (ERAS) recommendation 25–30

kkal/kg BW/day with balance of macronutrient composition. In SBS end

jejunostomy patient the food was given through distal feeding with adjusted

chymus drip to prevent dumping syndrome. There were increased in serum

albumin and body weight of the patients.

Conclusion: Adequate support medical therapy of clinical nutrition in IF patients give good outcome. ]"