[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.] |