Tesis

Profil Elektrolit dan Kejadian Sindrom Refeeding pada Anak Gizi Buruk Usia 6-59 Bulan = Electrolyte Profile and Incidence of Refeeding Syndrome in Malnourished Children 6-59 Months of Age.

Latar belakang:Berdasarkan pedoman World Health Organization (WHO) terkait penatalaksanaan pasien anak dengan gizi buruk, pemberian nutrisi kembali (refeeding) penting dilakukan secara bertahap. Walaupun demikian, beberapa anak yang telah ditata laksana nutrisi sesuai pedoman WHO mengalami sindrom refeeding. Sindrom refeeding terjadi akibat penurunan kadar kalium, fosfat dan magnesium darah dalam lima hari pertama setelah refeeding dimulai. Penelitian ini bertujuan mengetahui profil elektrolit dan kejadian sindrom refeeding pada anak gizi buruk. Metode: Penelitian ini merupakan studi kohor retrospektif periode Januari 2021 - Mei 2024 di RSUPN dr. Cipto Mangunkusumo Jakarta terhadap anak gizi buruk usia 6 -59 bulan dengan pengumpulan data elektrolit kalium, fosfat dan magnesium darah pada hari pertama perawatan sebelum tata laksana makan minimal satu pemeriksaan lagi sesudah makan selama lima hari pertama perawatan. Hasil: Terdapat 193 subyek dengan insidens gangguan elektrolit pada anak gizi buruk 60,6%, dengan hipofosfatemia terbanyak 51,8%. Insidens sindrom refeeding sebesar 18,1%, kejadian sindrom refeeding lebih besar secara bermakna pada kelompok yang tidak ada gangguan elektrolit hari pertama dibandingkan kelompok yang mengalami gangguan hari pertama.(p < 0.001). Kejadian sindrom refeeding terjadi paling tinggi pada hari kelima 16,5%, tetapi kejadian ini sudah ada di hari kedua 8,5%, ketiga 11,3% dan keempat 16,3%. Kesimpulan: Insidens gangguan elektrolit pada anak gizi buruk 60,6% sebelum intervensi nutrisi dengan hipofosfatemia 51,8%, hipokalemia 7,8%, dan hipomagnesemia 1,0% dan insidens sindrom refeeding sebesar 18,1%. Pemeriksaan fosfat, kalium, dan magnesium harus dilakukan lima hari berturut-turut.
Kata kunci: profil elektrolit, gizi buruk, sindrom refeeding


Background: According to the World Health Organization (WHO) guidelines for managing malnourished children, it is important to gradually restore nutrition. Refeeding syndrome is a condition of a series of metabolic and electrolyte changes as a result of adjustment or increased provision of calories after decrease or absence of caloric intake, resulting in a decerase in potassium, phosphate and magnesium in the first five days after nutrition. This study aims to determine the electrolyte profile and the incidence of refeeding syndrome severe acute malnutrition. Methods: This study is a retrospective cohort study conducted from January 2021 to May 2024 at Cipto Mangunkusumo Hospital Jakarta, for malnourished children aged 6-59 months by collecting electrolytes serum data of potassium, phosphate, and magnesium one at the beginning before eating and at least one examination after eating during the first 5 days of treatment. Results: There were 193 subjects with a prevalence of electrolyte disturbances in malnourished children of 60.6%, with most subjects with hypophosphatemia 51.8%. The incidence ofrefeeding syndrome in malnourished children was 18.1%, and the incidence of refeeding syndrome was significantly greater in the group with no electrolyte disorders on day 1 rather than in the group with electrolyte disorders on day 1. (p < 0.001) The incidence of refeeding syndrome peaked on the fifth day at 16.5%, but it was already observed on the second day at 8.5%, the third day at 11.3%, and the fourth day at 16.3%. Conclusion: The incidence of electrolyte disturbances in malnourished children was 60.6%, with most subject with hypophosphatemia 51.8%, hypokalemia 7,8%, dan hypomagnesemia 1,0% and the incidence of refeeding syndrome 18.1%. Phosphate, potassium and magnesium checks must be carried out five consecutive days.
Keywords: electrolyte profile, malnutrition, refeeding syndrome