Penatalaksanaan perdarahan saluran cerna bagian atas dengan nutrisi enteral dini terhadap kadar albumin

https://doi.org/10.22146/ijcn.22652

Virgianti Nur Faridah(1*), Farida Farida(2)

(1) Prodi S1 Keperawatan STIKES Muhammadiyah Lamongan
(2) Rumah Sakit Aisyiyah Bojonegoro
(*) Corresponding Author

Abstract


Background: Patients with upper gastrointestinal bleeding generally were decreased nutritional status that hypoalbuminemia because of increased albumin excretion from hemorrhage and patients fasted indefinitely until the bleeding stops. Enteral nutrition in patients with bleeding should be given to prevent malnutrition and reduce mortality.

Objective: To identify the differences in levels of albumin serum in the early enteral nutrition without waiting for the results of gastric lavage is clear (without fasting) and after 2-3 times the clear gastric lavage (fasted).

Method: The study used pre-experimental research design by static group comparison design. The study was conducted in RS Aisyiyah Bojonegoro in March to June 2015. The sample was 30 patients divided into 2 groups by Random Allocation, there was the treatment group I that fasted (15 patients), and treatment group II without fasted (15 patients). Analysis of data using Wilcoxon test Signed Ranks Test.

Results: The research found that there were differences in the provision of early enteral nutrition to albumin. Results showed that albumin level in patients who fasted lower than that without fasted. Results Statistics by Wilcoxon Signed Rank test with a 0.05 significance level values obtained 0,046, its means that H1 was accepted.

Conclusion: Patients with upper gastrointestinal bleeding can be given early enteral nutrition without waiting for the results gastric lavage clear rinse.


Keywords


upper gastrointestinal bleeding; early enteral nutrition; albumin serum

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References

  1. Adi, P. Pengelolaan perdarahan saluran cerna bagian atas. Buku Ajar Ilmu Penyakit Dalam (edisi IV Jilid I) (291-294). Jakarta: Pusat Penerbitan Departemen Ilmu Penyakit Dalam FK-UI; 2006.
  2. Barkun A, Sabbah S, Enss R, Redorak RN Amstrong D, Gregor J, et al. Canadian registry on non-variceal upper gastrointestinal bleeding and endoscopy (RUGBE): endoscopic hemostasis and proton pump inhibition are associated with improved outcomes in a real-life setting. Am J Gastroenterol 2004;99:1238-46.
  3. Lewis JD, Bilker WB, Brensinger C, Farrajt, Strom BL. Hospitalization and mortality rates from peptic ulcer disease and GI bleeding in the 1990s: relationship to sales of nonsteroidal anti-inflammatory drugs and acid suppression medications. Am J Gastroenterol 2002;97:2540-9.
  4. Lim CH, Vani D, Shah SG, Everett SM, Rembacken BJ. The outcome of suspected upper gastrointestinal bleeding with 24-hour access to upper gastrointestinal endoscopy: a prospective cohort study. Endoscopy 2006;38:581-5.
  5. Sudoyo, Aru W, Setiyohadi, Alwi, Simadibrata, dkk. Buku ajar ilmu penyakit dalam. Jakarta: Penerbit Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia; 2006.
  6. Roche M, Rondeau P, Singh NR, Tarnus E, Bourdon E. The Antioxidant properties of serum albumin. FEBS Lett 2008;582(13):1783-7.
  7. Wiryana M. Ventilator associated pneumonia. J Peny Dalam 2007;8(3):254-68.
  8. Soejono CH, Setiati S, Wiwie. Pedoman pengolahan kesehatan pasien geriatri: untuk kedokteran dan perawat. Jakarta: Penerbit FK UI; 2000.
  9. Daldiono H, Syam AF. Dasar-dasar nutrisi klinik pada proses penyembuhan penyakit. Buku Ajar Ilmu Penyakit Dalam (edisi IV Jilid I) (56-59). Jakarta: Pusat Penerbitan Departemen Ilmu Penyakit Dalam FK-UI; 2006.
  10. Daldiono H, Syam AF, Ingyanti S. Dukungan nutrisi pada kasus penyakit dalam nutrisi pada penyakit ulkus peptikum. Jakarta: Pusat Penerbitan Departemen Ilmu Penyakit Dalam FK-UI; 2006.
  11. Moenadjat Y. Petunjuk praktis penatalaksanaan luka bakar. Asosiasi Luka Bakar Indonesia. Jakarta: Komite Medik Asosiasi Luka Bakar Indonesia; 2005.
  12. Arikunto, Suharsimi. Prosedur penelitian suatu pendekatan praktik. Jakarta: Rineka Cipta; 2006.
  13. Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J 2010;9:69.
  14. Nursalam. Konsep dan penerapan metodologi penelitian ilmu keperawatan: pedoman skripsi, tesis dan instrument penelitian keperawatan. Jakarta: Salemba Medika; 2008.
  15. Siregar L, Rani AA, Manan C, Simadibrata M, Makmun D. Clinical profile and outcome of non-variceal upper gastrointestinal bleeding in relation to timing of endoscopic procedur in patients undergoing elective endoscopy. Indones J Gastroenterol Hepatol Digest Endosc 2011;12(3):140-5.
  16. Ohmann C, Imhof M, Ruppert C, Janzik U, Vogt C, Frieling T, et al. Time-trends in the epidemiology of peptic ulcer bleeding. Scand J Gastroenterol 2005;40:914-20.
  17. Syam AF, Setiawati A. Safety and efficacy of lansoprazole injection in upper gastrointestinal bleeding: a postmarketing surveillance conducted in Indonesia. Acta Med Indones 2013;45(2):123-9.
  18. Syam AF, Abdullah M, Makmun D, et al. The causes of upper gastrointestinal bleeding in the national referral hospital: evaluation on upper gastrointestinal tract endoscopic result in five years period. Indones J Gastroenterol Hepatol Digest Endosc 2005;6:71-4.
  19. Supriyanta. Pengaruh Suplementasi Modisco Putih Telur Terhadap Perubahan Kadar Albumin Dalam Darah Pasien Bedah dengan Hipoalbumin di IRNA Bedah RSUP Dr. kariadi Semarang. [URL: http://repository.ums.co.id] 2010 [cited tanggal 11 Januari 2015]
  20. Lim CH, Vani D, Shah SG, Everett SM, Rembacken BJ. The outcome of suspected upper gastrointestinal bleeding with 24- hour access to upper gastrointestinal endoscopy: a prospective cohort study. Endoscopy 2006;38:581-5.
  21. Lohsiriwat V, Lohsiriwat D, Boonnuch W, Chinswangwatanakul V, Akaraviputh T, Lert- akayamanee N. Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery. World J Gastroenterol 2008;14(8):1248-51.
  22. Reddy KM, Meyer CER, Palazzo FF, Conaghan P, Blunt MC, Stebbings WSL, Leicester RJ, Cullen PT. Postoperative stay following colorectal surgery: a study of factors associated with prolonged hospital stay. Ann R Coll Surg Engl 2003;85(2):111–4.
  23. Vincent JL, Dubois MJ, Navickis RJ, Wilkes MM. Hypoalbuminemia in acute illness: is there a rationale for intervention? a meta-analysis of cohort studies and controlled trials. Ann Surg 2003;237(3):319-34.
  24. Delgado-Rodríguez M, Medina-Cuadros M, Gómez- Ortega A, Martínez-Gallego G, Mariscal-Ortiz M, Martinez-Gonzalez MA, Sillero-Arenas M. Cholesterol and serum albumin levels as predictors of cross infection, death and length of hospital stay. Arch Surg 2002;137(7):805-12.
  25. Braunschweig C, Gomez S, and Sheean PM. Im- pact of declines in nutritional status on outcomes in adult patients hospitalized for more than 7 days. J Am Diet Assoc 2000;100:1316-22.
  26. Reddy KM, Meyer CER, Palazzo FF, Conaghan P, Blunt MC, Stebbings WSL, Leicester RJ, Cullen PT. Postoperative stay following colorectal surgery: a study of factors associated with prolonged hospital stay. Ann R Coll Surg Engl 2003;85(2):111–4.
  27. Yohanes Benny, Teguh Aryandono, Susetyowati. Hipoalbuminemia praoperasi pasien kanker kolorektal terhadap risiko komplikasi pascaoperasi dan lama rawat inap. Jurnal Gizi Klinik Indonesia 2013;9(4):170-178.
  28. Martini. Fundamentals Of Anatomy And Physiology Edition, Upper Sadle River. Jersey. Prestice Hall, Inc; 2006
  29. Price dan Wilson. Konsep Klinis Proses-Proses Penyakit. Edisi 6,vol 2. Jakarta: EGC; 2005.
  30. Supariasa. Gizi dalam Masyarakat. Jakarta: PT. Elex Media; 2001
  31. Ho KY and Kang JY. Esophageal mucosal acid sensitivity-Normal or abnormal?, AJG. 2000;35:310-311.
  32. Susetyowati, Ija M, Makhmudi A. Status gizi pasien bedah mayor preoperasi berpengaruh terhadap penyembuhan luka dan lama rawat inap pascaoperasi di RSUP Dr Sardjito Yogyakarta. Jurnal Gizi Klinik Indonesia 2010;7(1):1-7.
  33. Serpa LF, Kimura M, Faintuch J, Coconello I. Effects of continous versus bolus infusion of enteral nutrition in critical patients. Hosp. Clin.Fac.Med.S.Paulo.2003; 58(1):9- 14.
  34. Rock CL, Goldman L, Ausiello D. Saunders. Nutrition in the Prevaletion and treatment of disease. In: Cecil Textbook of Medicine 22nd; Philadelpia : Saunders; 2004.
  35. Bisri T. Terapi nutrisi pada pasien cedera kepala berat. In : Penanganan neuroanestesia dan cricital care cedera otak traumatik. Bandung: Saga Olahcitra. 2012; p. 229-40.
  36. Campos Machado FS. (2012). Nutrition therapy in severe head trauma patients. Bras Ter intensive. 2012; 24(1):97-105.
  37. Chen Y, Liu BL, Shang B, Chen AS, Liu SQ, Sun W, Yin HZ, Yin JQ, Su Q. Nutrition support in surgical patients with colorectal cancer. World J Gastroenterol 2011;17(13):1779-86.
  38. Ward N. Nutrition support to patients undergoing gastrointestinal surgery. Nutr J 2003;2:18
  39. Gramlich L, Kichian K, Pinilla S, Rodych N. Does enteral nutrition compared to parenteral nutrition result in better outcomes in critically ill adult patients? A systematic Review of the liferature. Nutrition.2004; 20 : 843-8.
  40. Supriyadi Bektiwibowo, Zakiudin Munasir, Sri Sudaryati Nasar. Pemberian Nutrisi Enteral kasus Bedah Anak: Pengaruh pada Status Nutrisi. Sari Pediatri.2005;7(3): 136 – 142
  41. Galban C, Montejo JC, Mesejo A, et al: An immune-enhancing enteral diet reduces mortality rate and episodes of bacteremia in septic intensive care unit patients. Crit Care Med 2000; 28:643–648
  42. Paul E. Marik, MD, FCCM; Gary P. Zaloga, MD, FCCM. Early enteral nutrition in acutely ill patients: A systematic review. Crit Care Med 2001; 29(12): 2264-2270
  43. Gibson S. Principles Of Nutrisional Assesment Second Edition, Oxford University, Press Inc, New York; 2005
  44. Restiana, Nurpudji A. Taslim, Agussalim Bukhari. Pengaruh Pemberian Ekstrak Ikan Gabus Terhadap Kadar Albumin Dan Status Gizi Penderita HIV/AIDS Yang Mendapatkan Terapi ARV. 2014. Available from : URL : http://pasca.unhas.ac.id/jurnal/files/5db462c0f32abe0c1eb16ec41c4ecf5e.pdf.



DOI: https://doi.org/10.22146/ijcn.22652

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