Pengaruh Nutritional Support terhadap Luaran Klinis pada Pasien Intensive Care Unit
Effect of Nutritional Support on Clinical Outcomes of Intensive Care Unit Patients
Latar Belakang: Dukungan gizi (nutritional support) pada pasien kritis merupakan standar perawatan yang diakui secara internasional dan bagian yang terintegrasi dari terapi klinik pada pasien Intensive Care Unit (ICU) yang bertujuan untuk memperbaiki luaran klinis pasien.
Tujuan: Penelitian ini adalah untuk menginvestigasi pengaruh pemberian nutritional support dalam bentuk nutrisi enteral terhadap luaran klinis pada pasien ICU.
Metode: Desain penelitian ini adalah sistematik review dari beberapa artikel penelitian dengan desain penelitian Randomized Controlled Trial (RCT) sejak tahun 2010 hingga 2020. Penulisan sistematik review ini mengacu pada ketentuan PRISMA. Luaran klinis yang diteliti meliputi: lama rawat inap di Rumah Sakit (RS), lama rawat inap di ICU, dan mortalitas.
Ulasan: Penelitian menunjukkan dari 897 artikel terdapat 6 artikel yang relavan. Responden penelitian merupakan pasien rawat inap di ICU yang mendapatkan formula enteral, baik responden pada kelompok kontrol maupun kelompok intervensi. Pada kelompok intervensi pasien mendapatkan formula enteral dengan modifikasi energi (normokalori dan tinggi protein) dan zat gizi (diperkaya dengan pektin dan immunonutrient). Dukungan gizi berupa nutrisi enteral memberikan efek yang bervariasi terhadap lama rawat inap di RS, ICU, dan mortalitas.
Kesimpulan: Lama rawat inap di ICU dan RS antara pasien yang mendapatkan nutrisi enteral standar/hipokalori/tinggi protein tidak berbeda bermakna dengan pasien yang mendapatkan nutrisi enteral yang diperkaya dengan pektin atau immunonutrient. Namun demikian, pasien yang mendapatkan nutrisi enteral dengan immunonutrient memiliki lama rawat inap yang lebih rendah. Hal yang perlu diperhatikan dari penelitian ini adalah pemberian immunonutrient dapat meningkatkan risiko mortalitas 60 hari dan 28 hari pada pasien kritis.
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