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"Latar belakang: merupakan salah satu tindakan pembedahan yang mempengaruhi motilitas gastrointestinal. Penelitian Cihoric et al menunjukkan sebanyak 12,5% pasien pasca laparotomi mengalami komplikasi disfungsi gastrointestinal. Disfungsi pada motilitas gastrointestinal merupakan komplikasi yang sering terjadi pada prosedur pembedahan abdomen. Dari 100 pasien operasi laparotomi digestif, ditemukan sebanyak 40% pasien di ICU mengalami peningkatan gastric residual volume pada pasien pasca operatif laparotomi digestif. Pemberian suplementasi dengan Lactobaciillus acidophilus diketahui dapat meningkatkan motilitas gaster.Tujuan: Penelitian ini bertujuan untuk mengetahui efek hubungan antara pemberian probiotik Lactobacillus acidophillus dengan GRV.Metode: Desain penelitian yang digunakan adalah eksperimental atau uji klinis acak tersamar ganda. Sebanyak 55 subjek yang mengikuti randomisasi, 54 subjek yang akan menjalani operasi laparotomi gastrointestinal dimasukkan ke dalam penelitian, 1 subjek drop out karena sepsis. Subjek penelitian diberikan kapsul probiotik Lactobacillus acidophilus 109 (kelompok probiotik) atau diberikan kapsul laktosa (kelompok plasebo) selama 3 hari sebelum operasi. Kadar GRV diukur 2 hari sesudah prosedur.Hasil: Dari 54 subjek dengan 27 subjek tiap kelompok mengikuti penelitian hingga selesai. Pada hari pertama (24 jam), GRV 24 jam dengan pemberian probiotik dan kelompok kontrol menunjukkan hasil yang tidak signifikan (p value 0,669). Pada hari ke 2 (48 jam), GRV 48 jam dengan pemberian probiotik dan kelompok kontrol menunjukkan hasil yang tidak signifikan (p value 1,000). Hasil yang tidak signifikan pada GRV 24 jam dan 48 jam dapat dipengaruhi faktor perancu yaitu geriatri, riwayat kelainan saraf, obesitas, riwayat penggunaan vasopressor, riwayat konsumsi opioid, hiperkapnia dan hiperglikemia selama di ICU.Simpulan: Pemberian probiotik Lactobacillus acidophilus dengan GRV tidak mempunyai efek hubungan dibandingkan dengan placebo.

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Background: Laparotomy is a surgical procedure that affects gastrointestinal motility. Research by Cihoric et al showed that 12.5% ​​of post-laparotomy patients experienced complications of gastrointestinal dysfunction. Dysfunction in gastrointestinal motility is a frequent complication of abdominal surgical procedures. Out of 100 patients with digestive laparotomy surgery, it was found that as many as 40% of patients in the ICU experienced an increase in gastric residual volume in postoperative digestive laparotomy patients. Supplementation with Lactobaciillus acidophilus is known to increase gastric motility.

Aim: This study aims to determine the effect of the relationship between administration of Lactobacillus acidophillus probiotics and GRV.

Methods: The study design used was an experimental or double-blind randomized clinical trial. A total of 55 subjects who followed the randomization, 54 subjects who would undergo gastrointestinal laparotomy were included in the study, 1 subject dropped out due to sepsis. Research subjects were given probiotic capsules Lactobacillus acidophilus 109 (probiotic group) or given lactose capsules (placebo group) for 3 days before surgery. GRV levels were measured 2 days after the procedure.

Results: Of the 54 subjects with 27 subjects in each group, they followed the research to completion. On the first day (24 hours), the 24-hour GRV with the administration of probiotics and the control group showed insignificant results (p value 0.669). On day 2 (48 hours), GRV 48 hours with probiotic administration and the control group showed insignificant results (p value 1,000). Results that were not significant at GRV 24 hours and 48 hours could be influenced by confounding factors, geriatrics, history of neurological disorders, obesity, history of vasopressor use, history of consumption of opioids, hypercapnia and hyperglycemia while in the ICU.

Conclusion: Administration of Lactobacillus Acidophilus probiotics with GRV had no association effect compared to placebo."

"Pendahuluan : Pemberian cairan jernih prabedah dapat menguntungkan pasien dalam masa perioperatif. Konsumsi cairan jernih maltodekstrin 12,5% dua jam prabedah dapat dilakukan terutama dalam ERAS ( Enhanced Recovery After Surgery). Penambahan protein dalam cairan jernih memberikan luaran yang lebih baik. Meskipun secara teoritis protein dapat memperlambat pengosongan lambung, perlu diketahui apakah cairan jernih yang mengandung kombinasi glukosa dan protein dapat mengakibatkan GRV ≥1,5 ml/kgBB ( risiko tinggi aspirasi) dua jam pasca konsumsi. Penelitian ini bertujuan untuk membandingkan GRV pasca pemberian cairan maltodekstrin 12,5% dengan cairan kombinasi glukosa dan protein.Metode: Penelitian uji klinis silang acak tersamar ini melibatkan 56 relawan berusia 25-40 tahun ( peserta didik Departemen Anestesiologi dan Terapi Intensif FKUI-RSCM). Peserta berkesempatan untuk mengkonsumsi dua jenis minuman prabedah, cairan maltodekstrin 12,5% dan cairan kombinasi glukosa dan protein (Fresubin Jucy®), dengan volume masing- masing 400 ml. Volume lambung diukur dua kali, setelah puasa selama minimal 6 jam, (GRV baseline), dan dua jam pasca konsumsi cairan. Peserta diberikan waktu washout dua minggu diantara kedua intervensi.Hasil: Tidak terdapat perbedaan bermakna pada GRV baseline sebelum pemberian kedua cairan intervensi ( p>0,05). Terdapat perbedaan yang signifikan pada GRV dua jam pasca konsumsi maltodekstrin 12,5% dengan cairan kombinasi ( p < 0,05). Secara teori protein dapat meningkatkan produksi leptin, dan menekan produksi ghrelin sehingga memperlambat waktu pengosongan lambung. Selain itu, faktor-faktor lain seperti osmolalitas dan jumlah kalori juga dapat mempengaruhi perbedaan GRV setelah puasa.Simpulan: Terdapat perbedaan signifikan pada GRV dua jam pasca pemberian cairan maltodekstrin 12,5% dengan cairan kombinasi glukosa dan protein.

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Introduction: Preoperative clear fluid administration have known for giving positive impacts for patients undergoing surgery. Drinking clear fluids containing carbohydrate, is already being a routine and many innovation on optimizing its composition are also being increasingly variative, one of them by adding protein. Theoretically, protein can slow gastric emptying, increasing gastric residual volume which can increase pulmonary aspiration risk. This study aimed to compare gastric volume after administration of 12.5% maltodextrin solution to clear fluid containing glucose and protein.

Methods: This randomized, double-blinded, crossover clinical trial involving 56 trainee anesthetists aged 25-40 years. Each participant consume two types of preoperative clear drinks, 12.5% maltodextrin and clear fluid containing glucose and protein. Gastric volume was measured twice, once after fasting for at least 6 hours, and two hours after drinking fluid. Every participants were given a two-week washout period before undergoing second intervention.

Results: No significant differences were found in the comparison of baseline gastric volume before intervention. Significant difference was found between gastric volume two hours after drinking maltodextrin compared to combination fluid ( p,0,05). This differences might be influenced by leptin increasing after drinking the combination fluid, along with the differences of fluid osmolarity and calories contained, affecting gastric emptying rate and residual volume. Conclusion: There was significant difference in gastric volume two hours after administration of 12.5% maltodextrin solution compared to combination of glucose and protein solution."

"Latar Belakang: Secara global diperkirakan terdapat 313 juta pembedahan yang dilakukan, dengan angka kematian 30 hari pascaoperasi mencapai 4.2 juta jiwa. Penilaian kondisi pasien preoperatif diperlukan untuk memprediksi morbiditas danmortalitas pasien pascabedah, maka modalitas yang digunakan dalam menilai risiko pembedahan sebaiknya memiliki akurasi dan objektivitas yang baik. Salah satu modalitas yang rutin digunakan di RSUPN Cipto Mangunkusumo (RSUPNCM) adalah skor ASA-PS. Namun skor ini sudah banyak ditinggalkan oleh negara maju dan beralih pada skor P-POSSUM yang dinilai lebih objektif, dan akurat. Studi ini menguji kesahihan skor P-POSSUM dalam memprediksi lama perawatan pasien pascabedah digestif mayor di ICU, yang mencerminkan keparahan morbiditaspascabedah. Tujuan: Studi ini menguji kemampuan kalibrasi dan diskriminasi skor P-POSSUM dalam memprediksi lama perawatan di ICU, dan menganalisis hubungan antar variabel skor P-POSSUM dengan lama perawatan di ICU pada pasien pasabedah digestif mayor. Metode: Studi ini merupakan studi kohort retrospektif di RSUPNCM selama Januari 2017 hingga Desember 2018. Sebanyak 289 subjek yang sesuai kriteria inklusi dianalisis dari data rekam medis. Lama perawatan pascabedah di ICU dan skor P-POSSUM subjek dicatat sesuai dengan data rekam medis. Variabel PPOSSUM yang berpengaruh terhadap lama perawatan subjek dianalisis dengan analisis bivariat dan regresi logistik multivariat. Kesahihan skor dinilai menggunakan uji kalibrasi Hosmer-Lemeshow dan uji diskriminasi dengan melihatnilai Area Under Curve. Hasil: Hasil analisis statistik menghasilkan bahwa skor P-POSSUM memiliki kemampuan kalibrasi yang baik (uji Hosmer-Lemeshow p=0.815) dan kemampuandiskriminasi yang cukup baik (AUC 77.8%, IK 95% 0.717-0.827). Variabel PPOSSUM yang secara statistik berpengaruh signifikan (p<0.05) terhadap lama perawatan di ICU adalah kadar natrium, jumlah perdarahan, laju jantung, dan EKG.Kesimpulan: Skor P-POSSUM sahih dalam memprediksi lama perawatan pasien pascabedah digestif mayor di ruang intensif (ICU).

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Background: It was estimated that there was 313 million surgery underwent worldwide, with the 30-days postoperative mortality rate reaching 4.2 million cases. The evaluation of preoperative patients’ conditions is encouraged to predict

postoperative morbidity and mortality, thus the modality used to assess surgery risk should be accurate and objective. RSUPN Cipto Mangunkusumo (RSUPNCM) routinely uses ASA-PS score to assess patients’ condition. Nonetheless, ASA-PS has

been regarded as subjective. Developed countries has started to replace this score with P-POSSUM score which was considered to be more accurate and objective. This study finds out the validity of P-POSSUM Score in predicting the length of

hospital stay in the ICU in patients who underwent digestive surgery, which reflects the severity of postoperative morbidity. Goals: This study investigated the calibration and discrimination ability of PPOSSUM score in predicting the length of stay in the ICU, and also explored the relationship between variables in P-POSSUM score and the length of stay in the ICU in patients who underwent digestive surgery.

Methods: This retrospective cohort study was conducted in RSUPNCM in January 2017 to December 2018 on 289 subjects who met the inclusion criteria. P-POSSUM score and the length of stay in the ICU unit were recorded, the data was taken from

medical record. Bivariate and multivariate logistic regression was used to investigate the relationship between P-POSSUM variables and the length of stay. The validity of P-POSSUM score was assessed by Hosmer-Lemeshow calibration

test and the measurement of the Area Under Curve (AUC).

Results: Statistical analysis showed that P-POSSUM had a good calibration ability (p=0.815 for Hosmer-Lemeshow test) and moderate discrimination ability (AUC 77.8%, CI 95% 0.717-0.827). Four P-POSSUM variables were found to be significantly associated with length of stay in the ICU (p<0.05), namely natrium level, total blood loss, heart rate and ECG. Conclusion: P-POSSUM score is valid in predicting the length of stay in the ICU in patients who underwent digestive surgery."

"Latar belakang: Laparotomi merupakan teknik operasi untuk membuka akses kavitas peritoneum dengan membentuk sayatan terbuka di area abdomen. Cedera mukosa akibat trauma pembedahan mengganggu homeostasis epitel, merusak ekosistem mikrobiom, meningkatkan produksi sitokin proinflamasi dan berkaitan dengan kejadian komplikasi pascaoperatif. Probiotik Lactobacillus acidophillus memperkuat sawar usus, mempertahankan ekosistem mikrobiom dan berpotensi memodulasi respon imun. Namun, belum terdapat penelitian mengenai dampak pemberian Lactobacillus acidophilus terhadap kadar c-reactive protein (CRP) pascalaparotomi gastrointestinal sebagai penanda inflamasiTujuan: Penelitian ini bertujuan untuk mengetahui dampak pemberian Lactobacillus acidophilus terhadap kadar CRP pascalaparotomi gastrointestinalMetode: Penelitian ini merupakan uji klinis acak tersamar ganda. Sebanyak 56 subjek yang akan menjalani operasi laparotomi gastrointestinal dimasukkan ke dalam penelitian. Subjek penelitian diberikan kapsul probiotik Lactobacillus acidophilus 109 (kelompok probiotik) atau diberikan kapsul laktosa (kelompok plasebo) selama 3 hari sebelum operasi. Kadar CRP diukur 3 hari sebelum prosedur dan 3 hari sesudah prosedur.Hasil: Lima puluh enam subjek dengan 28 subjek pada tiap kelompok, mengikuti penelitian hingga selesai. Pada hari ketiga pascaoperatif, probiotik secara efektif menurunkan peningkatan respon inflamasi dengan nilai akhir CRP pada kelompok probiotik lebih rendah dibandingkan kelompok plasebo (median probiotik 89,65 mg/L vs. plasebo 204 mg/L, p < 0,001). Perubahan peningkatan nilai CRP lebih rendah pada kelompok probiotik dibandingkan kelompok plasebo (median probiotik 84,8 mg/L vs. plasebo 187,6 mg/L, p < 0,001). Terdapat efek samping yang signifikan (mual, diare, muntah dan rasa kembung di perut) pada kelompok probiotik selama penelitian (p = 0,04).Simpulan: Pemberian probiotik preoperatif menurunkan secara signifikan peningkatan CRP pada pasien pascalaparotomi gastrointestinal

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Background: Laparotomy is a surgical technique to open access to the peritoneal cavity by forming an open incision in the abdominal area. Mucosal injury due to surgical trauma can disrupt epithelial homeostasis, impair the microbiome ecosystem, increase the production of proinflammatory cytokines and relating to the incidence of postoperative complications. Lactobacillus acidophillus probiotic administration improve the intestinal barrier function, maintains the microbiome ecosystem and potentially modulate immune responses. However, there has been no research on the impact of Lactobacillus acidophilus administration on C-Reactive Protein (CRP) levels after gastrointestinal laparotomy as a marker of inflammation.

Objective: This study aimed to determine the impact of Lactobacillus acidophilus on CRP levels after gastrointestinal laparotomy

Methods: This study is a randomized controlled trial. Fifty six subjects scheduled gastrointestinal laparotomy surgery were enrolled. Subjects received Lactobacillus acidophilus 109 probiotic capsules (probiotic group) or lactose capsules (placebo group) for 3 days before surgery. CRP levels were measured 3 days before the procedure and 3 days after the procedure.

Results: Fifty-six subjects with 28 subjects in each group completed the study. On the third postoperative day, probiotics effectively suppressed the elevating inflammatory response with the final CRP value in the probiotic group lower than the placebo group (median probiotic 89.65 mg/L vs. placebo 204 mg/L, p < 0.001). Elevated CRP values ​​were lower in the probiotic group than in the placebo group (median probiotic 84.8 mg/L vs. placebo 187.6 mg/L, p < 0.001). There was a significant side effects (nausea, diarrhea, vomiting, and bloating) in the probiotic group during study (p = 0.04).

Conclusions: Preoperative probiotic administration significantly reduced elevated CRP in patients After Undergoing Gastrointestinal Laporotomy."

"Masalah pemberian nutrisi merupakan salah satu yang sering terjadi pada bayi prematur disebabkan imaturitas sistem gastrontestinal dan menimbulkan peningkatan volume residual lambung. Memposisikan bayi pada posisi prone diketahui mempercepat penyerapan lambung, namun posisi prone mempunyai dampak negative meningkatkan abnormalitas postur, dan risiko sindrom kematian bayi mendadak. Salah satu alternatif yang dapat dilakukan adalah posisi quarter prone karena memiliki efektifitas yang sama dengan posisi prone tanpa efek samping yang merugikan. Penelitian ini bertujuan untuk mengidentifikasi pengaruh posisi quarter prone terhadap volume residual lambung bayi prematur. Penelitian ini menggunakan Randomized Control Trial RCT crossover design dengan 18 responden. Pemilihan sampel dengan simple random sampling. Hasil penelitian menunjukkan adanya pengaruh posisi quarter prone terhadap volume residual lambung bayi prematur dibandingkan dengan posisi supinasi p value 0,0001 . Pemberian posisi quarter prone efektif menurunkan volume residual lambung pada bayi prematur. Pemberian posisi ini dapat diterapkan sebagai salah satu tindakan keperawatan mandiri dalam mengoptimalkan pemberian nutrisi pada bayi prematur.

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The problem of nutritional management often occurs in preterm infants due to gastrointestinal immaturity lead increased residual volume. Positioning preterm infants on prone position considered to influence gastric emptying but prone position has a negative effect of increasing postural abnormalities, and risk of sudden infant death syndrome. An alternative can be done is quarter prone position because it has the same effectiveness with prone without adverse side effects. This study aims to identify the effect of quarter prone position on gastric residual. This research used Randomized Control Trial RCT crossover design simple random sampling with 18 respondents. The results showed the effect of quarter prone position on the gastric residual compared with supine position p 0.0001 . Positioned in quarter prone effective decreases gastric residual in preterm infants. It is suggested positioned in the quarter prone can be applied as one of independent nursing intervention in optimizing Nutritional management of the preterm infant."

"Latar Belakang. Pasien yang mengalami sepsis dan syok sepsis akan mengalami disfungsi organ akibat reaksi radikal bebas dengan sel endotel mikrovaskular sehingga menyebabkan tingkat morbiditas dan mortalitas yang cukup tinggi. Kondisi difungsi organ dapat diukur melalui perubahan kadar Interleukin-6 (IL-6), C-Reactive Protein (CRP), dan skor Sequential Organ Failure Assessment (SOFA) yang terjadi pada pasien-pasien tersebut. Pemberian asam askorbat yang memiliki kemampuan sebagai free radical scavenging, diharapkan dapat menurunkan proses peradangan atau inflamasi sehingga terjadi perbaikan fungsi organ. Penelitian ini bertujuan untuk mengetahui peran pemberian asam askorbat 6 gram secara intravena terhadap perubahan kadar IL-6, CRP, dan skor SOFA pada pasien sepsis dan syok sepsis di ruang perawatan intensif.Metodologi. Penelitian ini merupakan uji klinis dengan desain uji acak terkontrol, tersamar tunggal yang dilakukan terhadap pasien usia 18-65 tahun dengan diagnosis sepsis atau syok sepsis dalam perawatan 24 jam pertama masuk intensive care unit (ICU) RSUPN Dr. Cipto Mangunkusumo-Jakarta dan ICU RSUP H. Adam Malik-Medan sejak bulan Juli sampai dengan Desember 2019. Sebanyak 49 subyek dirandomisasi menjadi dua kelompok. Kelompok perlakuan (n=23), yang menerima vitamin C 1,5 gram per 6 jam selama 3 hari, dan kelompok kontrol (n=26), yang tidak menerima vitamin C tersebut. Pemeriksaan kadar IL-6, kadar CRP, dan skor SOFA dilakukan pada jam ke-24, 48, dan 72.Hasil. Tidak terdapat perubahan bermakna pada kadar IL-6 (P=0,423), CRP (P=0,080), dan skor SOFA (P=0,809) antara kelompok kontrol dan kelompok perlakuan.Kesimpulan. Pemberian asam askorbat 6 gram secara intravena tidak memberikan perubahan bermakna terhadap kadar IL-6, CRP, dan skor SOFA pada pasien sepsis dan syok sepsis di ruang perawatan intensif.

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Background. Septic and septic shock patients will have organ dysfunctions due to free radical reaction with microvacular endothelial cells, thus morbidity and mortality rate will increase in these conditions. Those organ dysfunctions can be measured through the changes of Interleukin-6 (IL-6) levels, C-Reactive Protein (CRP) levels, and Sequential Organ Failure Assessment (SOFA) scores. The administration of ascorbic acid has a feature known as free radical scavenging. The feature is expected to reduce the inflammatory rate in the organs and to improve the functions. This study was aimed to analyze the intravenous administration effect of 6 grams of ascorbic acid towards the changes of Interleukin-6 levels, C-Reactive Protein levels, and SOFA scores in septic and septic shock patients in intensive care unit

Methods. This was a single blind randomized controlled clinical trial study on patients aged 18-65 years old with septic and septic shock conditions in the first 24 hour care in intensive care unit (ICU) Dr. Cipto Mangunkusumo Hospital-Jakarta and H. Adam Malik Hospital-Medan from July to December 2019. In total, 49 subjects were included in the study and randomized into two groups. Intervetion group (n=23) received 1.5 gram/6 hours of vitamin C in three days consecutively, whereas the control group (n=26) did not receive the vitamin C. Measurements of IL-6 levels, CRP levels, and SOFA scores were performed in the 24th, 48th, and 72th hour.

Results. There were no significant changes of IL-6 levels (p=0.423), CRP levels (p=0.080), and SOFA scores (p=0.809) between the two groups.

Conclusion. The intravenous administration of 6 grams of ascorbic acid did not significantly affect the changes of Interleukin-6 levels, C-Reactive Protein levels, and SOFA scores in septic and septic shock patients in intensive care unit."

"Latar Belakang: Sepsis merupakan salah satu penyebab utama kematian di unit perawatan intensif. Dalam kasus infeksi, pemberian cairan intravena dan agen vasoaktif sangat direkomendasikan sebagai salah satu tatalaksana pasien sepsis. Namun, banyak studi yang belum dapat menunjukkan temuan positif sesuai dengan studi orisinil EGDT. Tujuan: Tujuan penelitian ini adalah mengetahui hubungan antara mortalitas pasien sepsis dengan waktu pemberian vasoaktif selama proses resusitasi cairan di Unit Perawatan Intensif Rumah Sakit Cipto Mangunkusumo. Metode: Studi ini menggunakan metode cohort retrospective dengan 188 subjek yang didapatkan melalui pemenuhan kriteria penelitian dari rekam medis pasien. Subjek dibagi menjadi dua kelompok, yaitu pasien sepsis yang mendapatkan terapi vasoaktif dalam enam jam pertama dan setelah enam jam. Hasil: Terdapat karateristik sosiodemografi dari subjek, antara lain jenis kelamin, usia, total cairan rerata, status transfusi, jenis cairan, jenis vasoaktif, penyakit penyerta, dan lama rawat di unit perawatan intensif. Dari hasil uji Chi-square didapatkan waktu pemberian vasoaktif terhadap mortalitas, bernilai P=0.282 dengan RR 1.060 95 CI 0.974-1.153. Diskusi: Hasil penelitian ini menunjukkan tidak adanya hubungan mortalitas dengan perbedaan waktu pemberian terapi vasoaktif tersebut.

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Background: Sepsis is the leading cause of death in intensive care unit. In case of infection, intravenous resuscitation and vasoactive agent are very recommended as one of the treatment for septic patient. However, many studies not yet able to show the positive findings in accordance with the EGDT original study.

Objectives: This study aims to find out the association between septic patient rsquo s mortality and the time of vasoactive administration during fluid resuscitation in Intensive Care Unit of Cipto Mangunkusumo Hospital.

Method: This is a cohort retrospective study with 188 subject which meet the criteria from medical record. The subjects are divided into two groups septic patients that are given vasoactive therapy within six hours and after six hours during fluid resuscitation.

Results: This study shows sociodemographic characteristics of the subjects, such as gender, age, total fluid average, transfusion status, type of fluid, type of vasoactive, comorbidities, and length of stay in ICU. Based on Chi Square test, relationship between mortality and timing of vasoactive administration, sequentially P 0.282 with RR 1.060 95 CI 0.974 1.153.

Discussion: No association between septic patient rsquo s mortality and time difference in administrating the vasoactive therapy. "

"Latar Belakang: Peningkatan volume residu lambung merupakan salah satu tanda intoleransi makan enteral. Intoleransi makan enteral adalah salah satu bentuk gangguan fungsi gastrointestinal. Ganguan fungsi gastrointestinal sering terjadi pada pasien dengan sakit kritis. Sistem skoring MSOFA adalah salah satu sistem skoring untuk menilai keparahan penyakit pada pasien kritis. Sistem skoring yang ada belum memasukkan gangguan fungsi gastrointestinal pada salah satu parameternya. Penelitian ini untuk mengetahui korelasi volume residu lambung dengan keparahan penyakit berdasarkan skor MSOFA, dan apakah volume residu lambung dapat menjadi parameter pelengkap sistem skoring MSOFA. Metode: Penelitian ini menggunakan desain kohort prospektif. Pengambilan data dilakukan pada bulan Februari - April 2014 di ICU RSCM. Total volume residu lambung diukur dari 24 jam pertama dan kedua. Skor MSOFA diukur pada hari I dan II. Data dikumpulkan menggunakan formulir penelitian. Data yang didapat dilakukan uji analisis statistik. Hasil: Sebanyak 72 subjek diikut sertakan dalam penelitian ini. Didapatkan perbedaan volume residu lambung yang bermakna pada 24 jam I dan II. Terdapat korelasi antara volume residu lambung 24 jam II dengan skor MSOFA hari II (p <0,001; r 0,544). Penambahan skor volume residu lambung pada skor MSOFA tidak menambah sensitivitas dan spesifisitas prediksi mortalitas pasien kritis. Kesimpulan: Terdapat korelasi antara volume residu lambung dengan keparahan penyakit yang dihitung berdasarkan skor MSOFA pada pasien yang dirawat d ICU RSCM. Penambahan skor volume residu lambung pada skor MSOFA tidak menambah sensitivitas dan spesifisitas prediksi mortalitas pasien kritis.

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Background: Increased gastric residual volume is a sign of food intolerance. Food intolerance is one form of gastrointestinal disorder. Gastrointestinal disorder often occurs in critically ill patients. MSOFA is one of the scoring system to assess disease severity in critically ill patients. Gastrointestinal system hasn't included in any scoring system. This study was to determine the correlation of gastric residual volume with disease severity based on MSOFA, and whether the gastric residual volume may be complementary parameters MSOFA scoring system.

Methods: This study used a prospective cohort design. Data collection was conducted in February-April 2014 in the ICU RSCM. Total gastric residual volume was measured in the first and second 24 hours of treatment. MSOFA score measured on day I and II.. Data were collected using a research form. Data obtained test statistical analysis.

Results: Total of 72 subjects enrolled in this study. Gastric residual volume difference was significant in the first and second 24 hours. There is a correlation between second 24-hour gastric residual volume with second day of MSOFA score (p <0.001; r 0,544). The addition of gastric residual volume score on the MSOFA scoring system did not add sensitivity and specificity of the prediction of critically ill patient mortality.

Conclusions: There is a correlation between gastric residual volume with disease severity scores that were calculated with MSOFA for patients admitted to the ICU RSCM. The addition of gastric residual volume score on the MSOFA scoring system did not add sensitivity and specificity of the prediction of critically ill patient mortality."

"Penelitian ini merupakan uji klitis paralel, membandingkan kelompok yang mendapat terapi gizi adekuat pascabedah (P) denga:n kelompok yang mendapatkan diet standnr RSUPNCM (K),Sebanyak 17 pasien pascabedah dige.stif yang dirawat di rua:og perawatan bedah kelas III RSUPNCM yang memenuhi kriteria dibagi dalam dua kelompok secara randomisasi blok. Data yang dlambil dari catatan medik pada awal perlal."UM meiiputi usijenis keiamin, lama operasi. jenis opemsi skor ASA, dan jumlah perdaran. Data asupan energi dan protein dengan food recorcL pemeriksaan antropometri (BB. PB dan IMT), dan laboratorium (kadar GDS dau MDA plasma) dilekukan padn awal dan akbir perlakuan. Anal isis data menggunakan uji t tidak berpasangan dan uji Mann Whitney dengan batas kemaknaan 5%.Sebanyak 9 orang kelompok P dan 8 orang kelompok K dengan rata rata usia 38,82±10,89 tahun mengil"Uti penelitian secara lengkap. Jenis opcrasi terbanyak yang dijalani subyek adalah reseksi-anastomosk Lama operasi :subyek perlakuan tergolong lama dan subyek kontrol tergolong singkat. Jumlah perdar.ahan tergolong sedikit. Data awal tidak menunjukkan pcrbedaan bermakna (p> 0,05). Setclah -enam hari perlakuan, didapatkan persentase asupan energi dan protein diba:ndingkan kebutuhan total termasuk kategori adekuat pada kelompok perlakuan dan tidak adekuat pada kelompok kontrol, dan perbedaan ini berm.akna (p<0,05). Pada kedua kelompok didapatkan peningkatan kadar ODS plasma yang lebih tinggi pada kelompok kontrol, namun secara statistik tidak bermakna (p> 0,05). Pada kelompok perlakuan terdapat pcnurunan kadar MDA plasma sedangkan pada kelompok kontrol terdapat peningkatan MDA plasma, meskipun secara statistik tidak berrnakna (p>0,05).Pada kedua kelompok didapatkan peningkatankadar GDS plasma yang lebih tinggi pada kelompok kontrol, namun secara ststistik tidak bermakna serta didapatkan penurunan MDA plasma pada kelompok perlakuan penelitian ini memperlihatkan terapi gizi dapat memperbaikistres metabolik dan oksidatif dibandingkan tanpa terapi gizi.

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The study was a parallel randomized clinical trial which compared the treatment group received postoperative adequate nutrition therapy (P) and tbe control group received hospital standard diet {K). Seventeen subjects postoperative digestive surgery admitted to Surgery Ward of Dr. Cipto Manguukusumo Hospital woeful filled the study criteria, were divided into two groups using block randomization. Data collection taken from medical record at the beginning of intervention were age, gender, duration of surgery, type of surgery, ASA score, and the amount of blood loss during surgery. Data of energy, and protein intake using food record, anthropometric (body weight, body Jength, and body mass index); and laboratory findings (plasma glucose and malondialdehyde levels) were done before and after intervention. For statistical analysis, unpaired t-test and Mann W1Iitney were used. The level of significance was 5%.Nine subjects in the treatment group and eight subjects in the control group whose mean of age is 38.82±10.89 years old completed the study. The most type of surgery was resection-anatomists. The duration of surgery "'as categorized as longtime in P and shortish inK groups. The amount of blood loss during surgery was little for both groups. The characteristic of the two groups were closely matched at base line (p> 0.05). After six days intervention. the percentage of energy and protein intake in treatment group were adequate in appropriate to the requirement, and these were statistically significant compared to control group (p<0.05). There were increase of plasma glucose levels in both groups which was higher in control group, however the increase wns not statisticaHy significant (p>0"05). Plasma levels of MDA were decrease in treatment group while in control group were increase eventhough the changes between the two groups were not ststitical significant (p>0.05). There were increase of plasma glucose level which was higher in the control group, although has not statistically significant, and there were decrose of plasma MDA levels in treatment group. This study revealed that nutrition therapy can improve metabolic and oxidative stress better than those without nutrition therapy."