Nutritional Management in Children with “Acute Respiratory Distress Syndrome, Decompensatio Cordis Sinistra et Dextra, Community-Acquired Pneumonia, and Marasmus”: A Case Study
Keywords:
nutritional management of malnutrition, marasmusAbstract
Children with heart failure complicated by comorbid conditions are at increased risk of growth failure and developmental delay, contributing to malnutrition such as stunting and marasmus. This study aims to explore the effects of nutritional management on a pediatric patient diagnosed with acute respiratory distress syndrome (ARDS), decompensatio cordis (left and right), community-acquired pneumonia (CAP), and marasmus using the Standardized Nutrition Care Process (NCP).
This case study applied an individualized approach for a pediatric patient in the PICU of Dr. Wahidin Sudirohusodo Hospital, Makassar. The research focused on nutrition screening, assessment, diagnosis, intervention, monitoring, and evaluation over a 10-day period.
Nutrition screening results indicated severe malnutrition with a score of 5 and comorbidities. The nutritional diagnosis was established under the domains of Nutrition Intake and Behavior. Anthropometric measurement of mid-upper arm circumference (MUAC) increased from 10 cm to 11 cm. Biochemical monitoring still indicated anemia. Nutrition-focused physical examination (NFPE) identified prominent ribs, loss of fat in the cheeks and triceps, and thinning hair. The child's intake of F100 formula via enteral feeding gradually increased during the transition phase, then progressed to the rehabilitation phase with soft oral foods, increasing from 70% to 100% of requirements. Continuous nutrition education and counseling led to improvements in feeding practices.
Individualized nutritional management was effective in increasing both enteral and oral intake and improving MUAC by 1 cm, thus preventing further muscle mass loss.
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