"[
ABSTRAK Latar belakang: Intestinal failure (IF) merupakan masalah pascabedah dengan
outcome yang buruk. Saat ini telah terdapat rekomendasi terapi gizi pada IF
berdasarkan etiologinya, namun belum ada laporan serial kasus yang memaparkan
aplikasinya.
Presentasi Kasus: Pasien dalam serial kasus ini terdiri dari 3 perempuan dan 1
laki-laki, berusia 21?42 tahun. Terhadap pasien ditegakkan diagnosis IF dengan
berbagai etiologi, yaitu 3 pasien dengan fistula enterokutan (FEK) dan 1 pasien
dengan short bowel syndrome (SBS) end jejunostomy. Terapi gizi pada pasien IF
berdasarkan etiologinya. Pada pasien FEK high output, kebutuhan energi 1,5?2
kali resting energy requirement (RER) atau 37?45 kkal/kg BB/hari, protein 1,5?2
g/kg BB/hari. Pada FEK low output kebutuhan energi 1?1,5 kali KEB (25?30
kkal/kg BB/hari), protein 1?1,5 g/kg BB/hari. Pada pasien FEK yang mendapat
terapi konservatif, didapat outcome peningkatan kadar albumin serum dan berat
badan, serta produksi fistel yang berkurang. Pasien FEK dengan persiapan
rekonstruksi usus halus terdapat perbaikan keadaan umum dan peningkatan kadar
albumin serum. Pada pasien SBS, terkait kondisi pascabedah maka terapi gizi
sesuai rekomendasi Enhanced Recovery After Surgery (ERAS), dengan
kebutuhan energi 25?30 kkal/kg BB/hari dengan komposisi makronutrien yang
seimbang. Pada pasien ini dilakukan distal feeding dan pengaturan laju tetesan
kimus untuk mencegah sindrom dumping. Pasien SBS didapat outcome
peningkatan 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 pooroutcome. Nowadays, many of nutritional management recommendations based onetiologies of IF, but no report about those application. Case Presentation: Three female and one male patients were included in this caseseries, aged 21?42 years old. Nutritional needs in IF patients are determined bytheir etiologies. IF in this case series caused by enterocutaneous fistula (ECF)and short bowel syndrome (SBS). Nutritional needs on ECF patients depend ontheir fistula production. In patients with high output ECF, energy requirement isin 1.5?2 resting energy requirement (RER) or 37?45 kcal/kg BW/day, protein1,5?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 givenconservative therapy, serum albumin and body weight increased, while the fistulaproduction decreased. In patients with preoperative of intestine reconstructionsurgery, there were improvement in general condition with the increase of serumalbumin. In SBS patients, related to the postoperative condition, energy was givenaccording to Enhanced Recovery after Surgery (ERAS) recommendation 25?30kkal/kg BW/day with balance of macronutrient composition. In SBS endjejunostomy patient the food was given through distal feeding with adjustedchymus drip to prevent dumping syndrome. There were increased in serumalbumin 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 pooroutcome. Nowadays, many of nutritional management recommendations based onetiologies of IF, but no report about those application. Case Presentation: Three female and one male patients were included in this caseseries, aged 21–42 years old. Nutritional needs in IF patients are determined bytheir etiologies. IF in this case series caused by enterocutaneous fistula (ECF)and short bowel syndrome (SBS). Nutritional needs on ECF patients depend ontheir fistula production. In patients with high output ECF, energy requirement isin 1.5–2 resting energy requirement (RER) or 37–45 kcal/kg BW/day, protein1,5–2 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 givenconservative therapy, serum albumin and body weight increased, while the fistulaproduction decreased. In patients with preoperative of intestine reconstructionsurgery, there were improvement in general condition with the increase of serumalbumin. In SBS patients, related to the postoperative condition, energy was givenaccording to Enhanced Recovery after Surgery (ERAS) recommendation 25–30kkal/kg BW/day with balance of macronutrient composition. In SBS endjejunostomy patient the food was given through distal feeding with adjustedchymus drip to prevent dumping syndrome. There were increased in serumalbumin and body weight of the patients. Conclusion: Adequate support medical therapy of clinical nutrition in IF patients give good outcome. ]"
