NUTRISI PADA PENDERITA SAKIT KRITIS

Abstract

Malnutrition is always been being associated with the increase of morbidity and mortality rate due to lack of immune
system, depending on ventilator, high rate of infection, and delayed healing process, so it will increase the cost and length of stay
of the patients. Clinician need to have right information about how to manage nutrition for critical ill patient because it will
influence the outcome of ICU patient.
Objective measurement nutritional status of the patient is difficult because process of illnesses itself will disturb the
method that will be used in the population. Nutritional status is multidimension phenomenon that need several methods for
measurement, including associated factors of nutrition, nutrition intake, and energy expenditure.
Nitrogen balance can be used to determine effectiveness of nutritional therapy. Nitrogen balance can be counted by formula
that count nitrogen in 24 hours from patch urine, especially urine urea nitrogen (UUN), minus nitrogen intake from the food.
Resting Energy Expenditure (REE) must be determined for nutritional therapy in critical ill patients. Acuracy estimation REE will
help to reduce complications due to overfeeding, such as infiltration fat to liver and pulmonyary compromise. Several methods are
available to predict REE such as Calorimetry, and Harris-Benedict equation.
The goal in nutritional therapy in critical ill patient is to support metabolic, not to complete their need in that time. Because
in critical ill patient there is no metabolic condition is able to metabolize total amount of calories to fulfill lack of energy expenses.
Ideally the route of nutritional therapy is able to supply nutrition with minimal morbidity. Each routes (parenteral and
enteral) have advantages and disadvantages, and the choice is depend on patient condition. In critical ill patient care, enteral
nutrition is always being the first choice and parenteral nutrition become the next alternative.