Provision of parenteral or enteral nutrition

Oct 13, 2025 by wbrum.org 43 views

Nutritional Status of Laparotomy Patients: A Study at Adam Malik Hospital Medan

Introduction

Laparotomy surgery, a common surgical procedure, can cause stress response to the body, increasing the risk of malnutrition, especially in patients undergoing this surgery. Malnutrition can increase the risk of negative results after operating. This study aims to evaluate perioperative nutritional status in patients who will undergo laparotomy surgery at the Adam Malik Hajj General Hospital in Medan.

Background

Laparotomy surgery is a major surgical procedure that involves making an incision in the abdominal wall to access the abdominal cavity. This surgery can cause stress response to the body, leading to increased levels of cortisol, adrenaline, and other hormones. These hormones can cause a decrease in appetite, increase in protein catabolism, and malabsorption of nutrients, ultimately leading to malnutrition. Malnutrition can increase the risk of postoperative complications, such as wound infections, delayed healing, and increased risk of mortality.

Methodology

This research is an observational study with a prospective design. This study involved 65 research subjects with non-probability sampling techniques, namely Consecutive Sampling. The study was conducted at the Adam Malik Hajj General Hospital in Medan, Indonesia. The research subjects were patients who were scheduled to undergo laparotomy surgery for digestive problems.

Results

The results showed that most research subjects had BMI ≥18.5, without weight loss> 3.6 kg in the last 6 months, without a history of food intake <50% portion in the last 1 week, and albumin value ≥3.0 pre and postoperatively. After surgery, the number of subjects with the pons value ≥1 changed from 33.85% before the operation to 52.31% after surgery. There is a significant change in the value of the pons before and after laparotomy (p = 0.001).

Discussion

The results of this study show that the perioperative nutritional status of laparotomy patients with digestive surgery at the Adam Malik Hajj Hospital Medan has decreased after surgery. This decrease in nutritional status can be attributed to several factors, including:

*** Body stress response: ** Operation triggers stress responses that can cause a decrease in appetite, increase in protein catabolism, and malabsorption of nutrients. *** Food restrictions: ** Patients are usually limited to food intake before and after surgery to prepare and recover from the procedure. *** Pain and discomfort: ** Postoperative pain can reduce the appetite and the ability of patients to consume sufficient amounts of food. *** Digestive disorders: ** Some patients may experience indigestion after surgery, which can affect the absorption of nutrients.

Conclusion

This study shows that the perioperative nutritional status of laparotomy patients with digestive surgery at the Adam Malik Hajj Hospital Medan has decreased after surgery. These results show the importance of monitoring and proper nutritional intervention to minimize the risk of postoperative complications. Doctors and nurses need to monitor the patient's nutritional status strictly before and after surgery, and do early intervention to prevent malnutrition. This intervention can include:

Consultation with Nutritionist: Nutritionist can provide advice about the right diet for patients before and after surgery. *Provision of parenteral or enteral nutrition: Additional nutrition through infusion or tube can be given to meet the nutritional needs of patients who cannot meet their needs through ordinary food. Early monitoring and intervention: Routine nutritional status monitoring and early intervention to overcome nutritional problems can help minimize the risk of postoperative complications.

Limitations

It is essential to note that this research was conducted in one hospital and the number of samples was limited. Further research with larger samples and different locations is needed to confirm the results of this study.

Recommendations

Based on the results of this study, the following recommendations are made:

Monitoring of nutritional status: Doctors and nurses should monitor the patient's nutritional status strictly before and after surgery.
Nutritional intervention: Early intervention to prevent malnutrition should be done, including consultation with a nutritionist, provision of parenteral or enteral nutrition, and early monitoring and intervention.
Further research: Further research with larger samples and different locations is needed to confirm the results of this study.

Implications

The results of this study have important implications in clinical practice. Doctors and nurses need to be aware of the potential risks of malnutrition in patients undergoing laparotomy surgery and take steps to prevent it. This study highlights the importance of monitoring and proper nutritional intervention to minimize the risk of postoperative complications.
Frequently Asked Questions (FAQs) about Perioperative Nutrition Status in Laparotomy Patients

Q: What is perioperative nutrition status?

A: Perioperative nutrition status refers to the nutritional condition of a patient before, during, and after surgery. It is essential to monitor and maintain a patient's nutritional status to prevent malnutrition and related complications.

Q: Why is perioperative nutrition status important in laparotomy patients?

A: Laparotomy surgery can cause stress response to the body, leading to increased levels of cortisol, adrenaline, and other hormones. These hormones can cause a decrease in appetite, increase in protein catabolism, and malabsorption of nutrients, ultimately leading to malnutrition. Malnutrition can increase the risk of postoperative complications, such as wound infections, delayed healing, and increased risk of mortality.

Q: What are the common factors that contribute to a decrease in perioperative nutrition status?

A: Several factors can contribute to a decrease in perioperative nutrition status, including:

Body stress response: Operation triggers stress responses that can cause a decrease in appetite, increase in protein catabolism, and malabsorption of nutrients.
Food restrictions: Patients are usually limited to food intake before and after surgery to prepare and recover from the procedure.
Pain and discomfort: Postoperative pain can reduce the appetite and the ability of patients to consume sufficient amounts of food.
Digestive disorders: Some patients may experience indigestion after surgery, which can affect the absorption of nutrients.

Q: What are the signs and symptoms of malnutrition in laparotomy patients?

A: The signs and symptoms of malnutrition in laparotomy patients may include:

Weight loss: Unintentional weight loss of more than 3.6 kg in the last 6 months.
Decreased appetite: Reduced appetite or difficulty consuming sufficient amounts of food.
Fatigue: Feeling weak or tired.
Hair loss: Excessive hair loss.
Skin problems: Dry, thin, or brittle skin.
Muscle wasting: Loss of muscle mass.

Q: How can perioperative nutrition status be monitored and maintained?

A: Perioperative nutrition status can be monitored and maintained by:

Consulting with a nutritionist: A nutritionist can provide advice about the right diet for patients before and after surgery.
Providing parenteral or enteral nutrition: Additional nutrition through infusion or tube can be given to meet the nutritional needs of patients who cannot meet their needs through ordinary food.
Early monitoring and intervention: Routine nutritional status monitoring and early intervention to overcome nutritional problems can help minimize the risk of postoperative complications.

Q: What are the implications of this study for clinical practice?

A: The results of this study have important implications in clinical practice. Doctors and nurses need to be aware of the potential risks of malnutrition in patients undergoing laparotomy surgery and take steps to prevent it. This study highlights the importance of monitoring and proper nutritional intervention to minimize the risk of postoperative complications.

Q: What are the limitations of this study?

A: This study was conducted in one hospital and the number of samples was limited. Further research with larger samples and different locations is needed to confirm the results of this study.

Q: What are the recommendations for future research?

A: Based on the results of this study, the following recommendations are made:

Monitoring of nutritional status: Doctors and nurses should monitor the patient's nutritional status strictly before and after surgery.
Nutritional intervention: Early intervention to prevent malnutrition should be done, including consultation with a nutritionist, provision of parenteral or enteral nutrition, and early monitoring and intervention.
Further research: Further research with larger samples and different locations is needed to confirm the results of this study.