TERAPI NUTRISI PADA PASIEN CARDIAC CACHEXIA ET CAUSA CHRONIC HEART FAILURE NYHA III DENGAN PENYULIT EDEMA PARU KARDIOGENIK AKUT
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Abstract
Pendahuluan Cardiac cachexia (CC) adalah penurunan berat badan dengan/ tanpa muscle wasting pada pasien gagal jantung. Terapi nutrisi merupakan salah satu upaya untuk mencegah perburukan klinis CC.
Laporan Kasus Ny.R, 54 tahun dikonsultasikan dengan diagnosa edema paru kardiogenik akut dan congestive heart failure NYHA III. Keluhan utama berupa masukan makan berkurang sejak 1 tahun dan memberat dalam 8 hari terakhir karena sesak napas. Ada riwayat penurunan berat badan, namun tidak diketahui besar penurunannya. Tampak lemah dan sesak napas. Antropometri: TB 154 cm, LLA 19.5 cm. Terdapat kehilangan jaringan lemak subkutan dan muscle wasting tanpa edema. Handgrip strength 5.2 kg. Food recall 24 hour 343 kkal. Status gizi buruk berdasarkan SGA. Terapi nutrisi: kalori 1600 kkal diberikan bertahap, dengan komposisi makronutrien: karbohidrat 45-50%, protein 1.5 gr/kgBBI/hari dan lemak 32-37%. Diberikan nutrient spesifik berupa EPA dan BCAA. Suplementasi mikronutrien: zink, curcuma, vitamin Bkompleks, thiamin dan ekstrak ikan gabus. Setelah Pasien dipulangkan, kami lakukan pemantauan selama 8 bulan untuk menilai asupan kalori, berat badan dan kapasitas fungsional serta kepatuhan pasien terhadap program terapi nutrisi yang diberikan. Terdapat perbaikan klinis peningkatan asupan energi, berat badan yang stabil, dan peningkatan kapasitas fungsional.
Kesimpulan Terapi nutrisi yang adekuat dan pemberian nutrient spesifik dapat mencegah perburukan CC.
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