Proses Asuhan Gizi Terstandar pada Pasien Obesitas Dengan Dekompensasi Gagal Jantung Akut Basah dan Hangat, Atrial Fibrilasi Respon Ventrikel Sedang, dan Gangguan Ginjal Akut: Sebuah Laporan Kasus

Unduhan
Latar Belakang: Obesitas disebabkan oleh ketidakseimbangan antara asupan energi berlebihan dan kurangnya aktivitas fisik dalam jangka waktu lama. Obesitas dapat meningkatkan risiko sindrom metabolik, termasuk risiko gagal jantung. Gagal jantung yang parah dapat meningkatkan risiko komplikasi seperti atrial fibrilasi dan gangguan ginjal akut. Sebagai langkah untuk mencegah meningkatnya tingkat keparahan gagal jantung pada pasien obesitas, diperlukan terapi diet kardiovaskular dengan prinsip cukup energi, rendah lemak, dan rendah protein yang diselenggarakan dalam rangkaian Proses Asuhan Gizi Terstandar (PAGT).
Tujuan: Mengetahui tatalaksana asuhan gizi terstandar pada pasien dengan pemberian diet kardiovaskuler pada pasien obesitas dengan gagal jantung, atrial fibrilasi, dan gangguan ginjal akut.
Metode: Studi kasus dilakukan pada bulan Februari 2023 pada pasien Rumah Sakit Khusus Infeksi (RSKI) Universitas Airlangga Surabaya
Hasil: Hasil evaluasi klinis menunjukkan adanya peningkatan kondisi fisik pada pasien dengan tidak adanya sesak napas dan tanda vital stabil di rentang normal pada akhir intervensi. Asupan pasien meningkat dari hari ke hari, tetapi terdapat beberapa pemenuhan zat gizi makro yang belum memenuhi target (<75%).
Kesimpulan: Pemulihan kondisi pasien terbilang cukup baik dengan hasil pemantauan fisik/klinis telah menunjukkan perubahan yang positif. Selain itu, pada asupan makanan terjadi peningkatan meskipun belum mencapai target asupan zat gizi makro.
Alpert, M. (2016) ‘Severe Obesity and Acute Decompensated Heart Failure: New Insights Into Prevalence and Prognosis', JACC: Heart Failure, 4(12), pp. 932–934. Available at: https://doi.org/doi.org/10.1016/j.jchf.2016.10.008.
Basuki, G. and Hartati, S. (2013) ‘Makna Obesitas', Jurnal EMPATI, 2(3), pp. 369–376. Available at: https://doi.org/doi.org/10.14710/empati.2013.7361.
Bimandoko, R. (2016) Hubungan Fibrilasi Atrium Terhadap Penurunan Fungsi Kognitif. Laporan Hasil Karya Tulis Ilmiah. Universitas Diponegoro.
Bottiroli, M et al. (2023) ‘Acute kidney injury in patients with acute decompensated heart failure-cardiogenic shock: Prevalence, risk factors and outcome', International Journal of Cardiology, 383(1016), pp. 42–49. Available at: https://doi.org/doi.org/10.1016/j.ijcard.2023.04.049.
Breidthardt, C., T et al. (2011) ‘Effect and Clinical Prediction of Worsening Renal Function in Acute Decompensated Heart Failure', Am J Cardiol., 107(5), pp. 730–735. Available at: https://doi.org/10.1016/j.amjcard.2010.10.056.
Chaudhry, S. and Abbasi, S. (2018) Acute Decompensated Heart Failure. Boston: Springer (Clinical Cases in Heart Failure).
Damayanti, BP. (2014) Hubungan Antara Hipertensi Dan Hipertrofi Ventrikel Kiri Pada Pasien Lansia Dengan Atrial Fibrilasi. Master's Thesis. Universitas Diponegoro.
Daryani, N.K. (2021) Asuhan Keperawatan Pasien Ny H Dengan Acute Decompensated Heart Failure Yang Mengalami Masalah Penurunan Curah Jantung Di Ruang Intermediate PJT RSUP Sanglah Denpasar Tanggal 24-26 April 2021. Master's Thesis. Poltekkes Kemenkes Denpasar Jurusan Keperawatan.
Dinicolantonio, J., Lucan, S. and O'Keefe, J. (2016) ‘The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease'. Progress in Cardiovascular Diseases', 58(5), pp. 464–472. Available at: https://doi.org/doi.org/10.1016/j.pcad.2015.11.006.
Farmakis, D. et al. (2018) ‘Acute heart failure: Epidemiology, classification, and pathophysiology', in Tubaro, M et al (ed.) Textbook of Intensive and Acute Cardiovascular Care (2 ed.). New York: Oxford University Press, pp. 459–469. Available at: https://doi.org/10.1093/med/9780199687039.003.0051_update_001.
Gangat, N. et al. (2021) ‘High-oxygen-affinity hemoglobinopathy-associated erythrocytosis: Clinical outcomes and impact of therapy in 41 cases', Am J Hematol., 96(12), pp. 1647–1654. Available at: https://doi.org/10.1002/ajh.26375.
Gherasim, L. (2019) ‘Troponins in Heart Failure – a Perpetual Challenge', MAEDICA – a Journal of Clinical Medicine, 14(4), pp. 371–377. Available at: https://doi.org/doi: 10.26574/maedica.2019.14.4.371.
Hsieh, C., Kuo, F. and Liao, C. (2022) ‘Heart Failure and Polycythemia: A Case Report and Literature Review', Acta Cardiol Sin, 38(4), pp. 532–535. Available at: https://doi.org/10.6515/ACS.202207_38(4).20220221C.
Kemenkes RI (2015) Pedoman Umum Pengendalian Obesitas. Available at. Available at: https://extranet.who.int/ncdccs/Data/IDN_B11_Buku%20Obesitas-1.pdf.
Kocabaş, M et al. (2020) ‘Clinical Characteristics And In-Hospital Outcomes Of Acute Decompensated Heart Failure Patients With And Without Atrial Fibrillation', Anatol J Cardiol., 23(5), pp. 260–267. Available at: https://doi.org/10.14744/AnatolJCardiol.2020.94884.
Kodliwadmath, A. and Khanra, D. (2020) ‘A Case of Heart Failure and Polycythemia: Treated with Phlebotomy', Journal of the Practice of Cardiovascular Sciences, 6(2), pp. 169–171. Available at: https://doi.org/10.4103/jpcs.jpcs_6_20.
Kohn, J. (2015) ‘Adjusted or Ideal Body Weight for Nutrition Assessment?', Journal Of The Academy Of Nutrition And Dietetics, 115(4), p. 680. Available at: https://doi.org/doi.org/10.1016/j.jand.2015.02.007.
Kurniagustina, R. (2018) Hubungan Pola Makan, Aktivitas Fisik, Dan Konsumsi Fast Food Dengan Obesitas Siswa Kelas V SDN 01 Kalisari Jakarta Timur Tahun 2018. Master's Thesis. Universitas Binawan.
Mafrici, B., Williams, H. and Barrett, M. (2021) Nutritional Consideration in Adult Patients With Acute Kidney Injury. (Think Kidneys NHS England). Available at: https://www.thinkkidneys.nhs.uk/aki/wp-content/uploads/sites/2/2021/03/Nutrition-Guide-2021.pdf.
Mifflin, M.D. et al (1990) ‘A new predictive equation for resting energy expenditure in healthy individuals', Am J Clin Nutr., 51(2), pp. 241–247. Available at: https://doi.org/10.1093/ajcn/51.2.241.
Mullens W, C.A. et al (2020) ‘Evaluation of kidney function throughout the heart failure trajectory – a position statement from the Heart Failure Association of the European Society of Cardiology', European Society of Cardiology, 22(4), pp. 584–603. Available at: https://doi.org/10.1002/ejhf.1697.
Njoroge, J. and Teerlink, J. (2021) ‘Pathophysiology and Therapeutic Approaches to Acute Decompensated Heart Failure', Circulation Research, 128(1468–1486), p. 10. Available at: https://doi.org/10.1161/CIRCRESAHA.121.318186.
Nursalim, A. and Yuniadi, Y. (2011) ‘Paradox Obesitas pada Pasien Gagal Jantung', Jurnal Kardiologi Indonesia, 32(4), pp. 207–208.
Pramesti, A. (2023) Asuhan Keperawatan Pada Ny S Dengan Diagnosa Medis Acute Decompensated Heart Failure (ADHF). Master's Thesis. Universitas Muhammadiyah Malang.
Rachmadi, D. (2011) ‘Gangguan Ginjal Akut (GnGA)', in Pustaka Ilmiah. Fakultas Kedokteran Universitas Padjadjaran.
Rahman, F., Roekmantara, T. and Romadhona, N. (2022) ‘Pengaruh Obesitas terhadap Kejadian Penyakit Jantung Koroner (PJK) pada Populasi Dewasa', Bandung Conference Series: Medical Science, 2(1), pp. 1002–1008. Available at: https://doi.org/doi.org/10.29313/bcsms.v2i1.1979.
Rampengan, S. (2014) Buku Praktis Kardiologi. Jakarta: Badan Penerbit Fakultas Kesehatan Indonesia.
Séguéla, P.,. Iriart, X.,. Acar, P.,. Montaudon, M.,. Roudaut, R. and Thambo, J. (2015) ‘Eosinophilic cardiac disease: Molecular, clinical and imaging aspects', Archives of Cardiovascular Diseases, 108(4), pp. 258–268. Available at: https://doi.org/doi.org/10.1016/j.acvd.2015.01.006.
Shahid, F., H., Gregory. and Shantsila, E. (2018) ‘Role of Monocytes in Heart Failure and Atrial Fibrillation', J Am Heart Assoc, 7(3), pp. 1–17.
Suharyati et al. (2019) Penuntun Diet Dan Terapi Gizi. 4th edn. Jakarta: EGC.
Susatiningsih, T. (2015) ‘Obesitas dan Stress Oksidatif', Jurnal Kesehatan Unila, 5(9), pp. 89–93.
World Health Organization (2021) ‘Obesity'. Available at: https://www.who.int/health-topics/obesity (Accessed: 25 July 2023).
Xiao, Y. (2011) ‘Cardiac arrhythmia and heart failure: From bench to bedside', Journal of Geriatric Cardiology, 8(3), pp. 131–132. Available at: https://doi.org/10.3724/SP.J.1263.2011.00131.
Hak Cipta (c) 2024 Elma Mutiara Oktaviani, Niken, Farapti, Trias Mahmudiono

Artikel ini berlisensiCreative Commons Attribution-ShareAlike 4.0 International License.
Media Gizi Kesmas by Unair is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
1. The journal allows the author(s) to hold the copyright and to retain the publishing right of the article without restrictions.
2. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution-Share-Alike (CC BY-SA).
3. The Creative Commons Attribution-Share-Alike (CC BY-SA) license allows re-distribution and re-use of a licensed work on the conditions that the creator is appropriately credited and that any derivative work is made available under "the same, similar or a compatible license”. Other than the conditions mentioned above, the editorial board is not responsible for copyright violations.
















