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"COVID-19 adalah penyakit infeksi yang menyebabkan morbiditas dan mortalitas yang tinggi pada kelompok usia lanjut dengan atau tanpa penyakit penyerta. Kondisi fisiologis lansia yang mengalami penurunan fungsi saluran cerna diperparah apabila terinfeksi COVID-19. Hal ini tergambar dari adanya kondisi intoleransi gastrointestinal yang ditemukan pada gambaran pasien lansia di ruang perawatan intensif (ICU). Studi kasus ini melaporkan asuhan keperawatan berdasarkan proses asuhan yang terdiri dari pengkajian, diagnosa, perencanaan, implementasi dan evaluasi yang dilakukan di ruang perawatan intensif. Gambaran pasien laki-laki lansia dengan usia 60 tahun terkonfirmasi COVID-19 derajat berat kritis dengan kondisi intoleransi gastrointestinal yang tergambar dari hasil observasi jumlah residu pada setiap shift. Pemberian nutrisi enteral dengan metode intermittent feeding diberikan di ruang intensif (ICU) efektif untuk mendukung penyerapan nutrisi yang lebih adekuat pada pasien. 

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COVID-19 is an infectious disease that causes high morbidity and mortality in the elderly or without comorbidities. Physiological conditions that experience decreased gastrointestinal function are exacerbated if infected with COVID-19. This is reflected in the presence of gastrointestinal intolerance conditions found in the description of elderly patients in the intensive care unit (ICU). This case study reports based on the nursing care process consisting of assessment, diagnosis, planning, implementation, and evaluation carried out in the intensive room. The description of a elderly male patient aged 60 years with confirmed COVID-19 critical degree with a gastrointestinal intolerance condition as illustrated by the observation of the amount of residue in each shift. Enteral nutrition with the intermittent feeding method is given in the intensive care unit (ICU) effective to support more adequate absorption of nutrients in patients. "

"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.

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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."

"Latar Belakang: Pengobatan Kanker kepala leher (KKL) melalui terapi radiasi maupun kemoradiasi sering menimbulkan efek samping. Efek samping terapi radiasi pasien KKL menyebabkan gangguan asupan yang meningkatkan kejadian malnutrisi. Ketersediaan jalur nutrisi enteral merupakan salah satu tata laksana nutrisi yang dapat diberikan untuk mencegah penurunan asupan dan status gizi pasien KKL. Penelitian ini bertujuan melihat korelasi antara ketersediaan jalur nutrisi enteral dengan pemenuhan nutrisi dan status gizi.Metode: Studi potong lintang dilakukan pada subjek dewasa dengan KKL pasca terapi radiasi di poliklinik radioterapi RSCM. Pemenuhan nutrisi dinilai dengan FFQ semi kuantitatif sedangkan status gizi diukur dengan menghitung indeks massa tubuh (IMT). Ketersediaan jalur nutrisi enteral didapatkan melalui wawancara dan rekam medis pasien.Hasil: Sebanyak 41 subjek penelitian dengan rerata usia 51 tahun ikut serta dalam penelitian. Sebagian besar subjek adalah laki-laki, diagnosis kanker nasofaring, stadium IV, dan jalur nutrisi oral. Rerata IMT subjek 20,5 ± 3,6 kg/m2 dan rerata asupan subjek 1336,7 ± 405,5 kkal/hari. Rerata IMT subjek dengan jalur nutrisi enteral lebih rendah dibandingkan dengan jalur nutrisi oral yaitu 18,2 ± 2,6 kg/m2 dibanding 21,2 ± 3,5 kg/m2. Rerata total asupan energi subjek dengan jalur nutrisi enteral lebih tinggi dibandingkan dengan jalur nutrisi oral yaitu 1498,1 ± 430,6 kkal/hari dibanding 1291,4 ± 393,3 kkal/hari. Terdapat korelasi nagatif sedang antara ketersediaan jalur nutrisi enteral dengan status gizi (r=-0,346, p=0,027) dan korelasi positif lemah dengan pemenuhan nutrisi (r=0,216, p=0,174). Meskipun demikian pada penelitian ini ditemukan bahwa proporsi subjek yang mendapat jalur nutrisi enteral dan mengalami penurunan IMT lebih sedikit dibandingkan dengan proporsi subjek yang menggunakan jalur oral, yaitu 22,2% dengan 43,8%.Kesimpulan: Terdapat korelasi negatif sedang yang signifikan antara ketersediaan jalur nutrisi enteral dengan status gizi dan korelasi positif lemah dengan pemenuhan nutrisi yang masih dipengaruhi oleh faktor perancu penelitian.

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Background: Treatment of head and neck cancer (HNC) through radiation therapy or chemoradiation often lead to side effects. The side effect of radiation therapy in HNC patients might deteriorate food intake that increase the incidence of malnutrition. The availability of enteral nutrition is one of nutritional interventions that can be provided to prevent detrimental of food intake and nutritional status in HNC patients. This study aims to evaluate the correlation between the availability of enteral nutrition with nutritional fulfillment and nutritional status.

Method: A cross sectional study was conducted on adult HNC patients after radiation therapy at Radiotherapy Outpatient Clinic of Dr. Cipto Mangunkusumo Hospital. Nutritional fulfillment was assessed by semi-quantitative food frequency questionnaire (FFQ) while nutritional status was measured by calculating body mass index (BMI). The availability of enteral route was obtained through interviews and patients medical records.

Results: A total of 41 subjects with a mean age of 51 years participated in the study. Most of the subjects were male, with stage IV nasopharyngeal cancer and oral nutrition route. The mean of BMI was 20,5 ± 3,6 kg/m2 and the mean food intake was 1336,7 ± 405,5 kcal/day. The mean BMI of subjects with enteral nutrition was lower than those on oral nutrition, which was 18,2 ± 2,6 kg/m2 compared to 21,2 ± 3,5 kg/m2. The mean total energy intake of subjects with enteral nutrition route was higher than oral nutrition route, which was 1498,1 ± 430,6 kcal/day compared to 1291,4 ± 393,3 kcal/day. There was a moderate negative correlation between the availability of enteral nutrition and nutritional status (r=-0,346, p=0,027), meanwhile there was a weak positive correlation with nutritional fulfillment (r=0,216, p=0,174). However, in this study we found that the proportion of subjects with enteral nutrition who experienced a decrease of BMI was less than the proportion of subjects on the oral route, which was 22,2% compared to 43,8%, respectively.

Conclusion: There is a moderate negative correlation between the availability of enteral nutrition which was statistically significant with nutritional status and a weak correlation with nutritional fulfillment which was still influenced by confounding factors."

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