When nutrition is required for
long-term or there is difficulty fitting the hose can be done in surgical or
endoscopic with esofagostomi, gastrostomi or jejonostomi. Speed of enteral
nutrition depends on the condition of patients. Patients with cancers of the
head where the neck is still gut can be given well a bolus 300-500 cc several
times per day, post-gastrectomy patients require administration by drip slowly
200 cc / hour, people with short bowel, malabsorption, radiation induced
enteritis 100 cc / hour.
Food ingredients for enteral
nutrition can be provided with nutritional counseling, may also use the enteral
nutrition formula had circulated on the market that in general there are two
categories based on the content of karohidrat that is full of fat and protein
digestion and partial digestion formula formula. There are preparations are
also high in protein or contain substances that are needed for improved its
Immunological status of patients.
Parenteral nutrition (NPE) is given
to sufficient sources of essential nutrients without the use of the gastrointestinal
tract of intravenously. NPE can be divided into partial NPE (NPE-P) and total
NPE (NPE-T) through peripheral or central vein. Tumors that affect the
digestive system or actions which involving the digestive system resulting in
impaired ingestion and digestion an indication of NPE. In granting the NPE
consider types of solutions are required in accordance with the needs of
macro-and micronutrients, note osmolarity of the solution (preferably less than
800-1000 mOsm / l and when it is not possible can be done infusion branch).
Needs macronutrient (carbohydrates
fats and proteins) of cancer patients is very individual several studies have
shown that about 50-60% of cancer patients who are treated feel abnormalities
expenditur resting energy (REE) are highly variable so it is difficult to
determine caloric needs in general. to determine the need for calories, should
be set in advance the goal of nutritional therapy and determine the factors
that influence it such as nutritional status, type of tumor, therapy should be
given to the tumor, presence of infection and disease duration. Calorie needs
for maintenance purposes is 115-130% of REE, while uintuk increase BB is
required to 150% REE. Measurement of REE based on Harnis Benedict formula: for
men REE (kcal / day) = 666 + (13.7 x weight) + (5 x TB) - (6.8 x age); women
REE (kcal / day) = 655 + (9.5 x weight) + (1.8 x TB) - (4.7 x age). BB is
weight in kilograms, TB is high bdan in cm, age in years. Patients can be added
around 20-50% of REE are given in the form non-protein calories to fulfill
energy during activity or in connection expenditur with illness. Energy needs
can also be estimated by multiplying as follows: BB x 30-35 kcal / day. Protein
requirement is 0.8 to 1.2 grams per kg BB per day. Patients with malnutrition
can be given 1.5 g / kg BW / day. Required polyunsaturated fatty acids
(linoleic acid) of about 2-4% of total calories and cholesterol <200 mg /
day.
Mikronitrien consists of vitamins,
minerals and elements frace. several studies have showed that deficiency of
certain vitamins, minerals and elements related frace with certain cancers.
Prompts consumption of vitamins are: Vitamin C 300 - 400 mg / day but some
researchers recommend vitamin C intake of 300-1000 mg reduce the risk of
cancer, Vitamin A (β - carotene) as anti-oxidants 25000-50000 IU, Vitamin E
100-400 units / day as an antioxidant. recommendation consumption of potassium,
sodium and chloride respectively 45-145 meq / day, calcium 60 meq / day,
magnesium 35 meq / day, and phosphate 23 mmol
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