PERBAIKAN KADAR ALBUMIN PASIEN POST AMPUTASI ET CAUSA LUKA BAKAR LISTRIK 25% DERAJAT III DAN STATUS GIZI KURANG DENGAN PEMBERIAN ASUPAN TINGGI PROTEIN
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Abstract
Pendahuluan
Proses penyembuhan luka post amputasi dan luka bakar dengan luas 25% dan kedalaman derajat III serta hipoalbuminemia sedang (albumin 2,6g/dL) dan status gizi kurang memerlukan terapi gizi spesifik tinggi protein.
Laporan Kasus
Tn.I, laki-laki, 28 tahun dikonsul oleh bagian bedah dengan luka post amputasi dan luka bakar listrik derajat III luas 25%. Keluhan utama asupan makan kurang sejak 16 hari terakhir karena nafsu makan kurang akibat nyeri pada luka post amputasi dan luka bakar. Ada nyeri ulu hati dan demam menggigil. Asupan 24 jam 1000kkal. Pasien didiagnosis dengan status gizi kurang (LLA=80,7%), status metabolik anemia normositik normokrom (Hb 9.7 g/dl), deplesi sedang sistem imun (TLC 940/µL), hipoalbuminemia (albumin 2,6g/dL) dan status gastrointestinal fungsional.
Terapi nutrisi dengan energi 2500 kkal, protein 2 gr/kgBBI/hari (23%), karbohidrat 57% dan lemak 20 %, melalui oral berupa makanan biasa 1250 kkal, ONS glutamine 2.5g/hari, suplementasi 6 butir putih telur (protein 31,5g/hari), vitamin C 1g/24jam, vitamin A 6.000IU/12jam, vitamin B1-100mg, vitamin B6-200mg, vitamin B12-200mg, Zinc 50mg/24jam, selenium 55µg, Curcuma 400mg/8jam dan ekstrak ikan gabus 2 kapsul/8 jam. Setelah perawatan 30 hari, terjadi perbaikan dalam penyembuhan luka, peningkatan LLA menjadi 23,5cm, peningkatan hemoglobin 9.3g/dl, peningkatan sistem imun (TLC 2064/µL), peningkatan albumin 3.9g/dL.
Kesimpulan
Terapi nutrisi spesifik dengan protein 2 gr/kgBBI dapat meningkatkan kadar albumin dan mempercepat penyembuhan luka pada pasien luka bakar.
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