7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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ASPEK MEDIS BEDAHDAN NUTRISI PARENTERAL
Drdr Akhmad Makhmudi SpB SpBASub Bagian Bedah Anak SM Bedah RSUP Dr Sardi$
akuaamp kedkeran UM
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TERMIN(L(I
NUTRISI)NUTRITI(N)NUTRIEN
TERAPI NUTRISI(RAL ENTERAL PARENTERAL
MALNUTRISI
PEM + MARASMIK MARASMIKK-ASHI(RK(R K-ASHI(RK(R
Skring Siampem M Laren
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PENDAHULUANMETAB(LISME01UMLAH SEMUA PR(SES ISIK DAN KIMIA
2AN MENHASILKAN DANMEMPERTAHANKAN 3AT HIDUP
TER(RANISASI +ANAB(LISME DAN 1UA TRANS(RMASI 2AN
MENHASILKAN ENERI 2AN DAPATDIUNAKAN (RANISME +KATAB(LISME
4 BI(TRANS(RMASI +D(RLAND
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PERI(PERATI5E
PREOPERATIVE DURANTEOPERATIVE P0STOPERATIVE
KATABOLISME
STARVASI
KATABOLISMESTRESS
TRAUMABEDAH
ANABOLISME
RECOVERY
(RAN 5ITAL
(TAK 1ANTUN
LI5ER
REN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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METAB(LISME BASAL
ENERI MINIMAL 2ANDIKEMBANKAN UNTUK MENUN1ANPERNAPASAN SIRKULASIPERISTALTIK T(NUS (T(T SUHUTUBUH AKTI5ITAS KELEN1AR DAN
UNSI 5EETATI TUBUH LAINN2A
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PENDAHULUAN DASAR TERAPI NUTRISI STRESS METAB(LIK TRAUMA LUKA
BAKAR PEMBEDAHAN RADI($ KHEM(TERAPI
KEBUTUHAN ENERI BASAL 4647K8AL$KBB$HARI
0 m airan ubuh ampeara dengan 0 K8a
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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SISA LUK(SE HABIS 4 9 1AM
LIK(EN DI HATI(T(T HABIS DALAMBEBERAPA 1AM N(RMAL UNTUK MENISISELA -AKTU ANTARA MAKAN
8ADANAN LEMAK 4 1AM KEMUDIAN
5IA LUK(NE(ENESIS DARI PR(TEIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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SUMBER ENERGI KARB( HIDRAT 47 9lt6 K8AL$KBB$HARI
+ASPEN 0==lt LUK(SE$DEgtTR(SE ISI(L(IS 7
RAM$KBB$HARI BILA BERLEBIHANMERUIKAN SEBAB RESPIRAT(R2U6TIENT DAN PR(DUKSI 8(4 NAIK
RASI( ENERI KH LEMAK ) 6lt6+ 66
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PEMBENTUKAN ENERI
KARB(HIDRAT PR(TEIN LEMAK
- - - - - - - - - - - - Pencernaan dan absorpsi - - - - - - - - - - - - - - -
ULA SEDERHANA ASAM AMIN( ASAM LEMAK
+eruamaLUK(SE LISER(L
Katabolisme
ASETIL 9 KA
SIKLUS ASAM 4H ATP SITRAT
Energi diampimpanDaam lt ampubampra ampb
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Kebutuhan lea Untu eenuh ebutuhan al$
ampa$an eul lea (be$an )-
+$a+bb atau $$ -10 (a$ttal al$ e$ha$2
Pebe$an lebh (a$ 30 (a$ al$ttal (aat en4ebab an eta(
L( t(a (be$an a(a a(a$t$+le$( lebh (a$ 100 +(l
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PR(TEIN STAR5ASINUTRISI TERHENTI C41AM
LUK(NE(ENESIS +PR(TE(LISIS TU
ALANIN 047 076 RAM$HARISETARA 466 9 lt66 RAM 1AR(T(T 2ANHILAN
DALAM lt 9 7 HARI 8ADANAN PR(TEINMEN8APAI TITIK KRITIS +BILA TETAP TAK
ADA MASUKAN ASAM AMIN(
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TERMIN(L(I
NUTRISI)NUTRITI(N)NUTRIEN
TERAPI NUTRISI(RAL ENTERAL PARENTERAL
MALNUTRISI
PEM + MARASMIK MARASMIKK-ASHI(RK(R K-ASHI(RK(R
Skring Siampem M Laren
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PENDAHULUANMETAB(LISME01UMLAH SEMUA PR(SES ISIK DAN KIMIA
2AN MENHASILKAN DANMEMPERTAHANKAN 3AT HIDUP
TER(RANISASI +ANAB(LISME DAN 1UA TRANS(RMASI 2AN
MENHASILKAN ENERI 2AN DAPATDIUNAKAN (RANISME +KATAB(LISME
4 BI(TRANS(RMASI +D(RLAND
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PERI(PERATI5E
PREOPERATIVE DURANTEOPERATIVE P0STOPERATIVE
KATABOLISME
STARVASI
KATABOLISMESTRESS
TRAUMABEDAH
ANABOLISME
RECOVERY
(RAN 5ITAL
(TAK 1ANTUN
LI5ER
REN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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METAB(LISME BASAL
ENERI MINIMAL 2ANDIKEMBANKAN UNTUK MENUN1ANPERNAPASAN SIRKULASIPERISTALTIK T(NUS (T(T SUHUTUBUH AKTI5ITAS KELEN1AR DAN
UNSI 5EETATI TUBUH LAINN2A
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 654
PENDAHULUAN DASAR TERAPI NUTRISI STRESS METAB(LIK TRAUMA LUKA
BAKAR PEMBEDAHAN RADI($ KHEM(TERAPI
KEBUTUHAN ENERI BASAL 4647K8AL$KBB$HARI
0 m airan ubuh ampeara dengan 0 K8a
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 754
SISA LUK(SE HABIS 4 9 1AM
LIK(EN DI HATI(T(T HABIS DALAMBEBERAPA 1AM N(RMAL UNTUK MENISISELA -AKTU ANTARA MAKAN
8ADANAN LEMAK 4 1AM KEMUDIAN
5IA LUK(NE(ENESIS DARI PR(TEIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 854
SUMBER ENERGI KARB( HIDRAT 47 9lt6 K8AL$KBB$HARI
+ASPEN 0==lt LUK(SE$DEgtTR(SE ISI(L(IS 7
RAM$KBB$HARI BILA BERLEBIHANMERUIKAN SEBAB RESPIRAT(R2U6TIENT DAN PR(DUKSI 8(4 NAIK
RASI( ENERI KH LEMAK ) 6lt6+ 66
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PEMBENTUKAN ENERI
KARB(HIDRAT PR(TEIN LEMAK
- - - - - - - - - - - - Pencernaan dan absorpsi - - - - - - - - - - - - - - -
ULA SEDERHANA ASAM AMIN( ASAM LEMAK
+eruamaLUK(SE LISER(L
Katabolisme
ASETIL 9 KA
SIKLUS ASAM 4H ATP SITRAT
Energi diampimpanDaam lt ampubampra ampb
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Kebutuhan lea Untu eenuh ebutuhan al$
ampa$an eul lea (be$an )-
+$a+bb atau $$ -10 (a$ttal al$ e$ha$2
Pebe$an lebh (a$ 30 (a$ al$ttal (aat en4ebab an eta(
L( t(a (be$an a(a a(a$t$+le$( lebh (a$ 100 +(l
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PR(TEIN STAR5ASINUTRISI TERHENTI C41AM
LUK(NE(ENESIS +PR(TE(LISIS TU
ALANIN 047 076 RAM$HARISETARA 466 9 lt66 RAM 1AR(T(T 2ANHILAN
DALAM lt 9 7 HARI 8ADANAN PR(TEINMEN8APAI TITIK KRITIS +BILA TETAP TAK
ADA MASUKAN ASAM AMIN(
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1854
N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PENDAHULUANMETAB(LISME01UMLAH SEMUA PR(SES ISIK DAN KIMIA
2AN MENHASILKAN DANMEMPERTAHANKAN 3AT HIDUP
TER(RANISASI +ANAB(LISME DAN 1UA TRANS(RMASI 2AN
MENHASILKAN ENERI 2AN DAPATDIUNAKAN (RANISME +KATAB(LISME
4 BI(TRANS(RMASI +D(RLAND
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 454
PERI(PERATI5E
PREOPERATIVE DURANTEOPERATIVE P0STOPERATIVE
KATABOLISME
STARVASI
KATABOLISMESTRESS
TRAUMABEDAH
ANABOLISME
RECOVERY
(RAN 5ITAL
(TAK 1ANTUN
LI5ER
REN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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METAB(LISME BASAL
ENERI MINIMAL 2ANDIKEMBANKAN UNTUK MENUN1ANPERNAPASAN SIRKULASIPERISTALTIK T(NUS (T(T SUHUTUBUH AKTI5ITAS KELEN1AR DAN
UNSI 5EETATI TUBUH LAINN2A
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 654
PENDAHULUAN DASAR TERAPI NUTRISI STRESS METAB(LIK TRAUMA LUKA
BAKAR PEMBEDAHAN RADI($ KHEM(TERAPI
KEBUTUHAN ENERI BASAL 4647K8AL$KBB$HARI
0 m airan ubuh ampeara dengan 0 K8a
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 754
SISA LUK(SE HABIS 4 9 1AM
LIK(EN DI HATI(T(T HABIS DALAMBEBERAPA 1AM N(RMAL UNTUK MENISISELA -AKTU ANTARA MAKAN
8ADANAN LEMAK 4 1AM KEMUDIAN
5IA LUK(NE(ENESIS DARI PR(TEIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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SUMBER ENERGI KARB( HIDRAT 47 9lt6 K8AL$KBB$HARI
+ASPEN 0==lt LUK(SE$DEgtTR(SE ISI(L(IS 7
RAM$KBB$HARI BILA BERLEBIHANMERUIKAN SEBAB RESPIRAT(R2U6TIENT DAN PR(DUKSI 8(4 NAIK
RASI( ENERI KH LEMAK ) 6lt6+ 66
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PEMBENTUKAN ENERI
KARB(HIDRAT PR(TEIN LEMAK
- - - - - - - - - - - - Pencernaan dan absorpsi - - - - - - - - - - - - - - -
ULA SEDERHANA ASAM AMIN( ASAM LEMAK
+eruamaLUK(SE LISER(L
Katabolisme
ASETIL 9 KA
SIKLUS ASAM 4H ATP SITRAT
Energi diampimpanDaam lt ampubampra ampb
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1054
Kebutuhan lea Untu eenuh ebutuhan al$
ampa$an eul lea (be$an )-
+$a+bb atau $$ -10 (a$ttal al$ e$ha$2
Pebe$an lebh (a$ 30 (a$ al$ttal (aat en4ebab an eta(
L( t(a (be$an a(a a(a$t$+le$( lebh (a$ 100 +(l
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PR(TEIN STAR5ASINUTRISI TERHENTI C41AM
LUK(NE(ENESIS +PR(TE(LISIS TU
ALANIN 047 076 RAM$HARISETARA 466 9 lt66 RAM 1AR(T(T 2ANHILAN
DALAM lt 9 7 HARI 8ADANAN PR(TEINMEN8APAI TITIK KRITIS +BILA TETAP TAK
ADA MASUKAN ASAM AMIN(
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1554
RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1854
N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 454
PERI(PERATI5E
PREOPERATIVE DURANTEOPERATIVE P0STOPERATIVE
KATABOLISME
STARVASI
KATABOLISMESTRESS
TRAUMABEDAH
ANABOLISME
RECOVERY
(RAN 5ITAL
(TAK 1ANTUN
LI5ER
REN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 554
METAB(LISME BASAL
ENERI MINIMAL 2ANDIKEMBANKAN UNTUK MENUN1ANPERNAPASAN SIRKULASIPERISTALTIK T(NUS (T(T SUHUTUBUH AKTI5ITAS KELEN1AR DAN
UNSI 5EETATI TUBUH LAINN2A
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 654
PENDAHULUAN DASAR TERAPI NUTRISI STRESS METAB(LIK TRAUMA LUKA
BAKAR PEMBEDAHAN RADI($ KHEM(TERAPI
KEBUTUHAN ENERI BASAL 4647K8AL$KBB$HARI
0 m airan ubuh ampeara dengan 0 K8a
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 754
SISA LUK(SE HABIS 4 9 1AM
LIK(EN DI HATI(T(T HABIS DALAMBEBERAPA 1AM N(RMAL UNTUK MENISISELA -AKTU ANTARA MAKAN
8ADANAN LEMAK 4 1AM KEMUDIAN
5IA LUK(NE(ENESIS DARI PR(TEIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 854
SUMBER ENERGI KARB( HIDRAT 47 9lt6 K8AL$KBB$HARI
+ASPEN 0==lt LUK(SE$DEgtTR(SE ISI(L(IS 7
RAM$KBB$HARI BILA BERLEBIHANMERUIKAN SEBAB RESPIRAT(R2U6TIENT DAN PR(DUKSI 8(4 NAIK
RASI( ENERI KH LEMAK ) 6lt6+ 66
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PEMBENTUKAN ENERI
KARB(HIDRAT PR(TEIN LEMAK
- - - - - - - - - - - - Pencernaan dan absorpsi - - - - - - - - - - - - - - -
ULA SEDERHANA ASAM AMIN( ASAM LEMAK
+eruamaLUK(SE LISER(L
Katabolisme
ASETIL 9 KA
SIKLUS ASAM 4H ATP SITRAT
Energi diampimpanDaam lt ampubampra ampb
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1054
Kebutuhan lea Untu eenuh ebutuhan al$
ampa$an eul lea (be$an )-
+$a+bb atau $$ -10 (a$ttal al$ e$ha$2
Pebe$an lebh (a$ 30 (a$ al$ttal (aat en4ebab an eta(
L( t(a (be$an a(a a(a$t$+le$( lebh (a$ 100 +(l
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1154
PR(TEIN STAR5ASINUTRISI TERHENTI C41AM
LUK(NE(ENESIS +PR(TE(LISIS TU
ALANIN 047 076 RAM$HARISETARA 466 9 lt66 RAM 1AR(T(T 2ANHILAN
DALAM lt 9 7 HARI 8ADANAN PR(TEINMEN8APAI TITIK KRITIS +BILA TETAP TAK
ADA MASUKAN ASAM AMIN(
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1454
-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1554
RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1654
PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1754
PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1854
N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 554
METAB(LISME BASAL
ENERI MINIMAL 2ANDIKEMBANKAN UNTUK MENUN1ANPERNAPASAN SIRKULASIPERISTALTIK T(NUS (T(T SUHUTUBUH AKTI5ITAS KELEN1AR DAN
UNSI 5EETATI TUBUH LAINN2A
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 654
PENDAHULUAN DASAR TERAPI NUTRISI STRESS METAB(LIK TRAUMA LUKA
BAKAR PEMBEDAHAN RADI($ KHEM(TERAPI
KEBUTUHAN ENERI BASAL 4647K8AL$KBB$HARI
0 m airan ubuh ampeara dengan 0 K8a
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 754
SISA LUK(SE HABIS 4 9 1AM
LIK(EN DI HATI(T(T HABIS DALAMBEBERAPA 1AM N(RMAL UNTUK MENISISELA -AKTU ANTARA MAKAN
8ADANAN LEMAK 4 1AM KEMUDIAN
5IA LUK(NE(ENESIS DARI PR(TEIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 854
SUMBER ENERGI KARB( HIDRAT 47 9lt6 K8AL$KBB$HARI
+ASPEN 0==lt LUK(SE$DEgtTR(SE ISI(L(IS 7
RAM$KBB$HARI BILA BERLEBIHANMERUIKAN SEBAB RESPIRAT(R2U6TIENT DAN PR(DUKSI 8(4 NAIK
RASI( ENERI KH LEMAK ) 6lt6+ 66
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 954
PEMBENTUKAN ENERI
KARB(HIDRAT PR(TEIN LEMAK
- - - - - - - - - - - - Pencernaan dan absorpsi - - - - - - - - - - - - - - -
ULA SEDERHANA ASAM AMIN( ASAM LEMAK
+eruamaLUK(SE LISER(L
Katabolisme
ASETIL 9 KA
SIKLUS ASAM 4H ATP SITRAT
Energi diampimpanDaam lt ampubampra ampb
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Kebutuhan lea Untu eenuh ebutuhan al$
ampa$an eul lea (be$an )-
+$a+bb atau $$ -10 (a$ttal al$ e$ha$2
Pebe$an lebh (a$ 30 (a$ al$ttal (aat en4ebab an eta(
L( t(a (be$an a(a a(a$t$+le$( lebh (a$ 100 +(l
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1154
PR(TEIN STAR5ASINUTRISI TERHENTI C41AM
LUK(NE(ENESIS +PR(TE(LISIS TU
ALANIN 047 076 RAM$HARISETARA 466 9 lt66 RAM 1AR(T(T 2ANHILAN
DALAM lt 9 7 HARI 8ADANAN PR(TEINMEN8APAI TITIK KRITIS +BILA TETAP TAK
ADA MASUKAN ASAM AMIN(
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1454
-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1554
RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1654
PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1754
PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1854
N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2054
MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2354
INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 654
PENDAHULUAN DASAR TERAPI NUTRISI STRESS METAB(LIK TRAUMA LUKA
BAKAR PEMBEDAHAN RADI($ KHEM(TERAPI
KEBUTUHAN ENERI BASAL 4647K8AL$KBB$HARI
0 m airan ubuh ampeara dengan 0 K8a
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 754
SISA LUK(SE HABIS 4 9 1AM
LIK(EN DI HATI(T(T HABIS DALAMBEBERAPA 1AM N(RMAL UNTUK MENISISELA -AKTU ANTARA MAKAN
8ADANAN LEMAK 4 1AM KEMUDIAN
5IA LUK(NE(ENESIS DARI PR(TEIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 854
SUMBER ENERGI KARB( HIDRAT 47 9lt6 K8AL$KBB$HARI
+ASPEN 0==lt LUK(SE$DEgtTR(SE ISI(L(IS 7
RAM$KBB$HARI BILA BERLEBIHANMERUIKAN SEBAB RESPIRAT(R2U6TIENT DAN PR(DUKSI 8(4 NAIK
RASI( ENERI KH LEMAK ) 6lt6+ 66
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 954
PEMBENTUKAN ENERI
KARB(HIDRAT PR(TEIN LEMAK
- - - - - - - - - - - - Pencernaan dan absorpsi - - - - - - - - - - - - - - -
ULA SEDERHANA ASAM AMIN( ASAM LEMAK
+eruamaLUK(SE LISER(L
Katabolisme
ASETIL 9 KA
SIKLUS ASAM 4H ATP SITRAT
Energi diampimpanDaam lt ampubampra ampb
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Kebutuhan lea Untu eenuh ebutuhan al$
ampa$an eul lea (be$an )-
+$a+bb atau $$ -10 (a$ttal al$ e$ha$2
Pebe$an lebh (a$ 30 (a$ al$ttal (aat en4ebab an eta(
L( t(a (be$an a(a a(a$t$+le$( lebh (a$ 100 +(l
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1154
PR(TEIN STAR5ASINUTRISI TERHENTI C41AM
LUK(NE(ENESIS +PR(TE(LISIS TU
ALANIN 047 076 RAM$HARISETARA 466 9 lt66 RAM 1AR(T(T 2ANHILAN
DALAM lt 9 7 HARI 8ADANAN PR(TEINMEN8APAI TITIK KRITIS +BILA TETAP TAK
ADA MASUKAN ASAM AMIN(
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1454
-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1554
RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1654
PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1754
PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1854
N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2054
MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2354
INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 754
SISA LUK(SE HABIS 4 9 1AM
LIK(EN DI HATI(T(T HABIS DALAMBEBERAPA 1AM N(RMAL UNTUK MENISISELA -AKTU ANTARA MAKAN
8ADANAN LEMAK 4 1AM KEMUDIAN
5IA LUK(NE(ENESIS DARI PR(TEIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 854
SUMBER ENERGI KARB( HIDRAT 47 9lt6 K8AL$KBB$HARI
+ASPEN 0==lt LUK(SE$DEgtTR(SE ISI(L(IS 7
RAM$KBB$HARI BILA BERLEBIHANMERUIKAN SEBAB RESPIRAT(R2U6TIENT DAN PR(DUKSI 8(4 NAIK
RASI( ENERI KH LEMAK ) 6lt6+ 66
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 954
PEMBENTUKAN ENERI
KARB(HIDRAT PR(TEIN LEMAK
- - - - - - - - - - - - Pencernaan dan absorpsi - - - - - - - - - - - - - - -
ULA SEDERHANA ASAM AMIN( ASAM LEMAK
+eruamaLUK(SE LISER(L
Katabolisme
ASETIL 9 KA
SIKLUS ASAM 4H ATP SITRAT
Energi diampimpanDaam lt ampubampra ampb
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1054
Kebutuhan lea Untu eenuh ebutuhan al$
ampa$an eul lea (be$an )-
+$a+bb atau $$ -10 (a$ttal al$ e$ha$2
Pebe$an lebh (a$ 30 (a$ al$ttal (aat en4ebab an eta(
L( t(a (be$an a(a a(a$t$+le$( lebh (a$ 100 +(l
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1154
PR(TEIN STAR5ASINUTRISI TERHENTI C41AM
LUK(NE(ENESIS +PR(TE(LISIS TU
ALANIN 047 076 RAM$HARISETARA 466 9 lt66 RAM 1AR(T(T 2ANHILAN
DALAM lt 9 7 HARI 8ADANAN PR(TEINMEN8APAI TITIK KRITIS +BILA TETAP TAK
ADA MASUKAN ASAM AMIN(
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1354
KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1454
-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1554
RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1654
PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1754
PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1854
N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2054
MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2354
INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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SUMBER ENERGI KARB( HIDRAT 47 9lt6 K8AL$KBB$HARI
+ASPEN 0==lt LUK(SE$DEgtTR(SE ISI(L(IS 7
RAM$KBB$HARI BILA BERLEBIHANMERUIKAN SEBAB RESPIRAT(R2U6TIENT DAN PR(DUKSI 8(4 NAIK
RASI( ENERI KH LEMAK ) 6lt6+ 66
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PEMBENTUKAN ENERI
KARB(HIDRAT PR(TEIN LEMAK
- - - - - - - - - - - - Pencernaan dan absorpsi - - - - - - - - - - - - - - -
ULA SEDERHANA ASAM AMIN( ASAM LEMAK
+eruamaLUK(SE LISER(L
Katabolisme
ASETIL 9 KA
SIKLUS ASAM 4H ATP SITRAT
Energi diampimpanDaam lt ampubampra ampb
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Kebutuhan lea Untu eenuh ebutuhan al$
ampa$an eul lea (be$an )-
+$a+bb atau $$ -10 (a$ttal al$ e$ha$2
Pebe$an lebh (a$ 30 (a$ al$ttal (aat en4ebab an eta(
L( t(a (be$an a(a a(a$t$+le$( lebh (a$ 100 +(l
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PR(TEIN STAR5ASINUTRISI TERHENTI C41AM
LUK(NE(ENESIS +PR(TE(LISIS TU
ALANIN 047 076 RAM$HARISETARA 466 9 lt66 RAM 1AR(T(T 2ANHILAN
DALAM lt 9 7 HARI 8ADANAN PR(TEINMEN8APAI TITIK KRITIS +BILA TETAP TAK
ADA MASUKAN ASAM AMIN(
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TIDAK BISA MAKAN TIDAK B(LEH MAKAN
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Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PEMBENTUKAN ENERI
KARB(HIDRAT PR(TEIN LEMAK
- - - - - - - - - - - - Pencernaan dan absorpsi - - - - - - - - - - - - - - -
ULA SEDERHANA ASAM AMIN( ASAM LEMAK
+eruamaLUK(SE LISER(L
Katabolisme
ASETIL 9 KA
SIKLUS ASAM 4H ATP SITRAT
Energi diampimpanDaam lt ampubampra ampb
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Kebutuhan lea Untu eenuh ebutuhan al$
ampa$an eul lea (be$an )-
+$a+bb atau $$ -10 (a$ttal al$ e$ha$2
Pebe$an lebh (a$ 30 (a$ al$ttal (aat en4ebab an eta(
L( t(a (be$an a(a a(a$t$+le$( lebh (a$ 100 +(l
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PR(TEIN STAR5ASINUTRISI TERHENTI C41AM
LUK(NE(ENESIS +PR(TE(LISIS TU
ALANIN 047 076 RAM$HARISETARA 466 9 lt66 RAM 1AR(T(T 2ANHILAN
DALAM lt 9 7 HARI 8ADANAN PR(TEINMEN8APAI TITIK KRITIS +BILA TETAP TAK
ADA MASUKAN ASAM AMIN(
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1754
PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Kebutuhan lea Untu eenuh ebutuhan al$
ampa$an eul lea (be$an )-
+$a+bb atau $$ -10 (a$ttal al$ e$ha$2
Pebe$an lebh (a$ 30 (a$ al$ttal (aat en4ebab an eta(
L( t(a (be$an a(a a(a$t$+le$( lebh (a$ 100 +(l
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PR(TEIN STAR5ASINUTRISI TERHENTI C41AM
LUK(NE(ENESIS +PR(TE(LISIS TU
ALANIN 047 076 RAM$HARISETARA 466 9 lt66 RAM 1AR(T(T 2ANHILAN
DALAM lt 9 7 HARI 8ADANAN PR(TEINMEN8APAI TITIK KRITIS +BILA TETAP TAK
ADA MASUKAN ASAM AMIN(
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1454
-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1554
RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1654
PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1754
PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1854
N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2054
MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2354
INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1154
PR(TEIN STAR5ASINUTRISI TERHENTI C41AM
LUK(NE(ENESIS +PR(TE(LISIS TU
ALANIN 047 076 RAM$HARISETARA 466 9 lt66 RAM 1AR(T(T 2ANHILAN
DALAM lt 9 7 HARI 8ADANAN PR(TEINMEN8APAI TITIK KRITIS +BILA TETAP TAK
ADA MASUKAN ASAM AMIN(
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1354
KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1454
-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1554
RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1654
PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1754
PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1854
N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2054
MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2354
INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1454
-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KEBUTUHAN PR(TEIN KEBUTUHAN PR(TEIN) K(NSUMSI NITR(EN gt 47
K(NSUMSI NITR(EN M$4 1AM) UREUM URIN$4
1AM gt 4 666M MM(L$L
TANPA STRESS METAB(LIK
PR(TEIN+AA) 0 lt R$KBB$HARI
KAL(RI ) lt6 K8AL$KBB$HARI
DENAN STRESS METAB(LIK KAL(RI ) 6 K8AL$KBB$HARI PR(TEIN +AA ) 4 R$KBB$HARI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1554
RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1754
PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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-H2 IS NUTRITI(N
IMP(RTANT
ENER2 ( DAIL2 LI5IN
MAINTENAN8E ( ALL B(D2UN8TI(NS
5ITAL T( R(-TH ANDDE5EL(PMENT+ INANT8HILDREN
THERAPEUTI8 BENEITS
HEALIN
PRE5ENTI(N IMMUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1554
RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1654
PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1754
PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1854
N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2054
MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2354
INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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RUMUS HARRIS BENEDI8T
+K8AL$HARI
BEE PRIA ) 7 0lt F BB+K
7 F T+8M 9 gt U+THN BEE -ANITA)77 =7 gt BB+K
0 gt T+8M gt U+THN
BB)Bera badan T)Tinggi badan U)Uampia
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1654
PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1854
N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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PERHITUNAN KAL(RI DENAN
STRESS FACTOR
AEE)BEE gt STRESSFACTOR gt 047
STRESS FACTOR K(REKSI
KELAPARAN 670 066
PAS8A BEDAH 066 067
SEPSIS 0lt6 9 076
LUKA BAKAR 06lt6G 076
LUKA BAKAR lt676G 07
LUKA BAKAR C 76G 466
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1754
PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1854
N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2054
MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2354
INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1754
PR(BLEM PERI(PERATI DAN
MALNUTRISI
STRESS METAB(LIK +STAR5ASI INEKSITRAUMA EBRIS BEDAH LUKA BAKAR
DIPUASAKAN HIP(LIKEMIA DEHIDRASI K(NDISI KLINIS PEN2AKIT +underlying
disease ABD(MEN AKUT ILEUS STRANULASI
PERIT(NITIS DAN PERDARAHANILEUS K(MPRESI DEHIDRASI INEKSI
TUM(R cancer cachexia-anorexia PEM +Prein Energi manuriampi
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1854
N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2054
MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2354
INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N TOMI GIT
Aulla 5 Vate$
Gat$amp utlet
Pe4e$4 atamph 5 l4h(
L+2T$et6
Melaena
Heat
amphe6a
Reamptalblee(n+
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 1954
AKUT ABD(MEN ILEUS STRANGULASI PERITONITIS PERDARAHAN KOMBINASI-TRAUMA
ILEUS7 PROBLEM
KOMPRESI-DEHIDRASIDAN IN8EKSI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2054
MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2054
MEG COLON
CONGENIT L
(HIRSCHSPRUNG DISE SE)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2354
INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2154
H(- T( S(L5E THE
PR6BLEM T( PER(RM NUTRITI(N 8ARE
A8TI5ITIES NUTRITI(NAL ASSESSMENT NUTRITI(NAL REUIREMENTS R(UTES ( DELI5ER2 (RMULA $ I5 SELE8TI(N M(NIT(RIN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2354
INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2254
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2354
INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2354
INDIKASI TERAPI NUTRISI
PARENTERAL +TNPE
TIDAK MAU MAKAN
TIDAK 8UKUP MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2454
TIDAK BISA MAKAN TIDAK B(LEH MAKAN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2554
Parenteral Nutrition
Central or Total (TPN) For long term use catheters are surgically
placed May have surgically implanted catheters
which lie beneath the skin and are accessedby special needle to decrease risk o
inection Can add solution o higher osmolarity into
central vein (larger lumen)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2654
Pa$ente$al Nut$tn Peripheral (PPN)
hort term parenteral support (up to weeks)
ypertonic solutions ($ ampamp msm) maycause phlebitis thus must limit PPNsolution+s osmolarity
nergy and protein provided by PPN are
limited because de-trose and amino acidscontribute signiicantly to osmolarity lectrolytes also contribute to osmolarity
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2854
K(NTRA INDIKASI TNPE
KRISIS HEM(DINAMIK S2(KDEHIDRASI + k$I MUTLAK AAL NAAS TANPA
RESPIRAT(R DAN PASIENKEANASAN TUM(R PADAASE TERMINAL +k$I RELA TI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 2954
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3054
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3154
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3254
Nasogatric tube
boy 0 months1 230 kg 04 cm
monthslater
1 amp35 kgs
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3354
K(MPLIKASI PARENTERAL
NUTRISI HIPERLIKEMI HIP(LIKEMI
UREMI PRERENAL ANUAN UNSI HATI ANUAN 8AIRANELE8TR(LIT
DEISIENSI TRA8E ELEMEN$5ITAMIN HIPER8APNI 8(4 C
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3454
Pediatric parenteral amino acid
solution 6nant
Primene 47 (8a-ter983214) minosteril 6nant (Fresenius983214)
Pediatric minousin Paed (8a-ter983214) minosteril (Fresenius983214)9
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3554
Parenteral Access Peripheral ccess
ccess by placing catheter into a
peripheral vein Peripheral Parenteral Nutrition (PPN)
Central ccess ccess by catheter into vein eeding
into the superior vena cava
Total Parenteral Nutrition (TPN)
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3654
Monitoring 6ndicators 8ody weight 6ntakeoutput
8owel unction 8lood glucose erum electrolytes
8lood ureanitrogen creatinine
erum phosphorus iver unction tests erum calcium and
magnesium
erum transerrin hour urinary
nitrogen erum albumin
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3754
AL(RITME PEREN8ANAANTERAPI NUTRISI
MENILAI STASUS GI9I DAN KONDISI KLINIK PENDERITAI
HITUNG KEBUTUHAN NUTRISIene$+ $ten lea elet$lt (ll
IMEMILIH KOMPOSISI TERAPI NUTRISI
IMENENTUKAN TEKNIK lt SKEMA
PEMBERIANTERAPI NUTRISI
IMONITOR7
E8EK TERAPI NUTRISIKOMPLIKASI
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3854
TERAPI NUTRISI PARENTERAL EBB PHASE 7 CAIRAN RESUSITASI RL ASERING 8LO= PHASE 7 CAIRAN NUTRISI
KH 7 D D)0 PROTEIN 7 ASAM AMINO )0 LEMAK 7 LIPID 0 ELEKTROLIT
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 3954
DASAR PEMBERIAN NUTRISI
PARENTERAL IMBAN PR(TEIN P(SITIP
PERHITUNAN ENERI
RUMUS HARRIS BENEDI8T +ka$hari
BEE Pria )70ltFBB+kgT+mFU+h
BEE-ania)77=7FBB+kg0FT+mFU+h
MALNUTRISI AEE ) 04 gt BEE
STRESS AKT(R PUASA ) 67066 AEE ) BEE gt STRESS AKT(R gt047
BEE)Basic Energy Expenditure
AEE) Actual Energy Expenditure
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4054
K(MP(SISI KIMIA
TUBUHLEMAK+T07 Kg
Subkuan
Inermuampkuar
Inraabdmen
Inraraka
PR(TEIN04 Kg
MINERAL LIK(EN
4 Kg
AIR 40 K
LEMAK
MASSA TUBUH
NON LEMAKgt AIR
Data (a$
Be((e ()1
PRIA UMUR 6 TAHUN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4154
K(MP(SISI KIMIA TUBUHKH7 GLUKOSE
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4254
PROGRAM CAIRAN
1JUMLAH CAIRAN
2JENIS CAIRAN3CARA PEMBERIAN
4MONITORING
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4354
TOTAL BODY WATER ( ASHCRAFT )
UMUR
Gestasia 12 $iamp 4
12 $iamp 32 $iamp (
Ate$
3+ -ai ( +3
Neatamps + (
C-ie 0 +
amp Ma 0amp $a
Oe 0 eas $a
Oe 0 eas 5$e 4
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4454
MAINTENANCE ( ASHCRAFT )
6 7ai 8ampi Re9ampie$ets
Weight Volume
Premature (lt 2kg ) 150 ml kg
Neonatus amp infant (2-10 kg ) 100mlkg for first 10kg
Infant amp hilren (10-20kg ) 1000ml50mlkg oer 10 kg
$hilren ( 20 kg ) 1500ml20mlkg oer 20 kg
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4554
umlah airan
1 7eisit aia lt e-iasi
a 7e-iasi Ria = $ltgt TB )
7e-iasi Sea 1 =1$ltgt TB )
7e-iasi Beat 1 =1$ltgt TB )6 Tisitas aa-Hitisistis-ietis
2 Maiteae
Neatamps 24 a$ st eati igtampai 3
3 Pegtiaa aia -ia aa$ 24 a$
= i ss )
2D3 $iiati t 8ampi itagte = see tae )
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4654
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4754
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4854
STAN7ART PAE7IATRIC
MAINTENANCE SOLUTION
UMUR LARRISTALOI7
1+2 -ai 71 = tagt e- eegttit )
3+ -ai 7 NaC B1( 6
F 1 t- 7 NaC B22 6
F 1 t- 7 NaC B4 6
Tambahkan Maintenance KCl 75
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 4954
Useful Intravenus Slutns Cerall$
Avalale
Sampti 7etse Na C Latate Ca
$lt $E9lt
7 ) + + + + +
71) 1)) + + + + +
Nlt1+7 ) 14 14 + + +
Nlt2+7 ) + + +
Nlt4+7 ) 3( 3( + + +
Nlt+7 ) 31 31 + + +R L + 13) 1)( 4 2( 2
A$iampsi Pae + 3) 1) 2 + 1)
Ita Lii 1) + + + + + +
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
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KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5054
N()( P+ +)+(I( Na $l- $a (setate atate- lukosa alori 3)((N
m+sm alaeN 1 4 22 675 675 6875 150 500
aeN 6 ( 290 0 50 10 20 28 10 500
aeN 6 4 290 50 50 20 20 28 10 500
aeN )6 95 50 50 20 20 100 00 500
5001000
(sering 2867 160 1078 278 2 500
ampOMOSISI ELEampTROLIT ( EL )
+)P+II ((N ( 3N (N (3IN
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5154
CONTOH KASUS Se$an+ la-la ua 0 tahun BB 10
+ tn++ ba(an )0 amp2 Pen(e$ta
($aat a$ena lua baa$ 0 Den+an $uu Ha$$ Bene(ampt7
BEE 332 )210)0
320)02 ampalha$
St$e 5aampt$lua baa$ 0 )2
AEE )02 )2)2 ) ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5254
Be$at ba(an aen 0 + Tana t$e etabl7
al$ 00 ampal )00 ampal
eb2 Aa An 0) +$aha$
D+ t$e etabl7
Kal$ 010 ampal 000ampalha$
A An 0 )00 +$aha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5354
KASUS ANAK La-la uu$ ) tahun BB 3 + TB 30amp D7 Ileu (en+an
Deh($a be$at 5eb$ 10C (an alnut$ be$at2 Pe$htun+an7 ) Gan++uan tablta7 ebb phase (RL ASERING)
P$+$a ampa$an 3 Fa7 )ampal )l ebutuhan ampa$an - ulah ampa$an7 antenen )0 l (eh($a ) )03gt0 30 l
5eb$ 10C )3 l - Ttal $euta ampa$an 3 l Bla n( tabl (fow phase)7 ampa$an nut$ enaan
be$taha
- KH 7 KAEN A l- PROTEIN 7 AMINO8USIN l
- LEMAK 7 LIPID 0 l Malnut$ be$at 7 BEE 00 ampalha$
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
7232019 S1 Aspek Medis Bedah ampParenteral Nutrition Sept14pptx
httpslidepdfcomreaderfulls1-aspek-medis-bedah-parenteral-nutrition-sept14pptx 5454
Thank you
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