Week 5

Asuhan Gizi pada Pasien Kegawatan Bedah

metabolisme protein dan asam amino pada penyakit kritis: dari perubahan fisiologis hingga praktik
klinis yang relevan

respon metabolik terhadap cedera

Respon Metabolik terhadap Cedera

Assessment
Kondisi fisik/klinis pasien menunjukkan: KU lemah, kesadaran 453, RR 28/menit, Suhu 37˚C, Nadi
80x/menit, Tensi 128/75mmHg, nafas spontan. Kesadaran: Apatis
Pada tanggal 24 Februari pasien mendapatkan Kabiven 1440 ml/24 jam dan D5% 6x50 ml melalui
NGT
• Kabiven 1440 ml  E: 1000 kkal, KH: 97 g, P: 54 g, L: 51 g
 • D5% 300 ml  KH: 15 g, E: 51 kkal
• Total  E: 1051 kkal, KH: 112 g, P: 54 g, L: 51g
Tinggi Badan Perempuan= (1,83 x tinggi lutut(cm)) – 0,24 x umur(th)) + 84,88  82,35 – 12 + 84,88 =
155 cm

• BBI: 49,5 kg

Perhitungan Kebutuhan Zat Gizi

Protein : 15-25%

CHO : 50-65%

Guidelines Energy Requirements Protein Requirements

ASPEN 2016 Use IC 1.2–2 g/kg/day

In the absence of IC use Obesity: high protein,
25–30 kcal/kg/day (EC) BMI 30–40 = 2.0 g/kg IBW/
Obesity: hypocaloric day; BMI ≥ 40 = up
nutrition, to 2.5 g/kg IBW/day (EC)
65-70% measured
requirements
by IC. If no IC, BMI 30–50 =
11–14 kcal/kg ABW/day;
BMI > 50 =22–25 kcal/kg
IBW/day (EC)
Lipids : 15-30%

Guidelines Energy Requirements Protein Requirements

ESPEN (2019) Use IC (grade B) 1.3 g/kg/day delivered

In the absence of IC use progressively (grade 0)
VO2 Obesity: 1.3 g/kg ABW/day
or VCO2 predictive (grade 0)
equations
(grade 0) Obesity: if no IC,
20–25 kcal/kg ABW/day
(grade 0)