tag:blogger.com,1999:blog-40313082220946986652024-03-13T13:53:55.456-07:00Wahid Blog | Blogger ArchiveAnonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.comBlogger24125tag:blogger.com,1999:blog-4031308222094698665.post-25364062711153220602016-08-19T18:17:00.001-07:002016-08-19T18:17:17.666-07:00galery<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBqqJUq23iDbjNpWgY8zOH7IthfpUg22nN8EpuwtV6iRFvl7kC2QlsOIjPWFjKxaPjo9RenMveLojh46k_vw7gjuRDFo8XGSC1-x2jZ-nrqtmTKMmYVSOo85nQyrh2-fYmlWUD9nY9nZc/s1600/FB_IMG_1433104846867.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBqqJUq23iDbjNpWgY8zOH7IthfpUg22nN8EpuwtV6iRFvl7kC2QlsOIjPWFjKxaPjo9RenMveLojh46k_vw7gjuRDFo8XGSC1-x2jZ-nrqtmTKMmYVSOo85nQyrh2-fYmlWUD9nY9nZc/s640/FB_IMG_1433104846867.jpg"> </a> </div><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrtm6jz3sFNXHfd4uMXckxtXIvySI84aYpaIIyr4mNj8sqmNzxkqSa3eQeQ5Gar9nMa4bRsVRJpHFMFZwneLxnPB2LNpMnRnptcNziLvjhc2Zi27qqLkDEk9W6E3VsiJq1_n4IG3pkHg8/s1600/FB_IMG_1433104840640.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrtm6jz3sFNXHfd4uMXckxtXIvySI84aYpaIIyr4mNj8sqmNzxkqSa3eQeQ5Gar9nMa4bRsVRJpHFMFZwneLxnPB2LNpMnRnptcNziLvjhc2Zi27qqLkDEk9W6E3VsiJq1_n4IG3pkHg8/s640/FB_IMG_1433104840640.jpg"> </a> </div>Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-44349572596721088512016-04-29T07:25:00.001-07:002016-04-29T07:25:52.779-07:00Jadwal Pertandingan Arema di ISC/TSC 2016<p dir="ltr">Minggu, 01 Mei 201618:30 WIB AREMA CRONUS VS PERSIBA</p>
<p dir="ltr">Jumat, 06 Mei 201621:00 WIB MADURA UNITED VS AREMA CRONUS</p>
<p dir="ltr">Minggu, 15 Mei 201618:30 WIB AREMA CRONUS VS BHAYANGKARA SURABAYA UNITED</p>
<p dir="ltr">Jumat, 20 Mei 201619:00 WIB MITRA KUTAI KARTANEGARA VS AREMA CRONUS</p>
<p dir="ltr">Jumat, 27 Mei 201621:00 WIB AREMA CRONUS VS PERSEGRES GRESIK UNITED</p>
<p dir="ltr">Minggu, 12 Juni 201619:30 WIB PSM VS AREMA CRONUS</p>
<p dir="ltr">Minggu, 19 Juni 201619:30 WIB AREMA CRONUS VS PERSIJA</p>
<p dir="ltr">Minggu, 26 Juni 201619:30 WIB PERSIPURA VS AREMA CRONUS</p>
<p dir="ltr">Jumat, 01 Juli 201621:30 WIB AREMA CRONUS VS SEMEN PADANG</p>
<p dir="ltr">Minggu, 17 Juli 201619:00 WIB PERSELA VS AREMA CRONUS</p>
<p dir="ltr">Jumat, 22 Juli 201621:00 WIB AREMA CRONUS VS PERSERU</p>
<p dir="ltr">Selasa, 26 Juli 201619:00 WIB BARITO PUTERA VS AREMA CRONUS</p>
<p dir="ltr">Minggu, 31 Juli 201619:00 WIB AREMA CRONUS VS PS TNI</p>
<p dir="ltr">Minggu, 07 Agustus 201619:00 WIB BALI UNITED VS AREMA CRONUS</p>
<p dir="ltr">Minggu, 14 Agustus 201619:00 WIB SRIWIJAYA FC VS AREMA CRONUS</p>
<p dir="ltr">Sabtu, 20 Agustus 201619:00 WIB AREMA CRONUS VS PUSAMANIA BORNEO FC</p>
<p dir="ltr">Sabtu, 27 Agustus 201619:00 WIB PERSIB VS AREMA CRONUS</p>
<p dir="ltr">-----------------<br>
-----------------</p>
<p dir="ltr">Jumat, 02 September 201621:00 WIB AREMA CRONUS VS MADURA UNITED</p>
<p dir="ltr">Minggu, 11 September 201619:00 WIB PERSIBA VS AREMA CRONUS</p>
<p dir="ltr">Sabtu, 17 September 201621:00 WIB BHAYANGKARA SURABAYA UNITED VS AREMA CRONUS</p>
<p dir="ltr">Jumat, 30 September 201621:00 WIB AREMA CRONUS VS MITRA KUTAI KARTANEGARA</p>
<p dir="ltr">Jumat, 07 Oktober 201621:00 WIB PERSEGRES GRESIK UNITED VS AREMA CRONUS</p>
<p dir="ltr">Jumat, 14 Oktober 201619:00 WIB AREMA CRONUS VS PSM</p>
<p dir="ltr">Rabu, 19 Oktober 201619:00 WIB PERSIJA VS AREMA CRONUS</p>
<p dir="ltr">Jumat, 21 Oktober 201621:00 WIB AREMA CRONUS VS PERSIPURA</p>
<p dir="ltr">Jumat, 28 Oktober 201621:00 WIB SEMEN PADANG VS AREMA CRONUS</p>
<p dir="ltr">Minggu, 06 November 201619:00 WIB AREMA CRONUS VS PERSELA</p>
<p dir="ltr">Minggu, 13 November 201616:00 WIB PERSERU VS AREMA CRONUS</p>
<p dir="ltr">Jumat, 18 November 201621:00 WIB AREMA CRONUS VS BARITO PUTERA</p>
<p dir="ltr">Jumat, 25 November 201619:00 WIB PS TNI VS AREMA CRONUS</p>
<p dir="ltr">Selasa, 06 Desember 201619:00 WIB AREMA CRONUS VS SRIWIJAYA FC</p>
<p dir="ltr">Minggu, 11 Desember 201619:00 WIB PUSAMANIA BORNEO FC VS AREMA CRONUS</p>
<p dir="ltr">Sabtu, 17 Desember 201619:00 WIB AREMA CRONUS VS PERSIB</p>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-19824113673711847912016-03-17T09:17:00.003-07:002016-03-17T09:17:56.546-07:00Jadwal Kalender MotoGP 2016 Trans7 dan Jam Tayangan Siaran Langsung (Live Race) <div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span style="color: #0b5394;">B</span></b>agi Anda para penggemar MotoGP dan ingin mengetahui <b>Jadwal Kalender MotoGp 2016 di </b>Trans7 lebih awal, berikut adalah kalender 2016 MotoGP selengkapnya.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQnNNZilZNHuElubo-3X_8hFhIUYcSwqxIcZJdVhlTngEKDOnimpu1uVUTfgEO_fqG3QlO3jkrSxUVivydupw4PQ_F_S_qx2DX3ndtt7BztY4HDm0yzSacrrkl3hs-qvhyphenhyphen0XyL4QH7uvw/s1600/Jadwal+MotoGP+2016+Live+Trans+7+-+1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQnNNZilZNHuElubo-3X_8hFhIUYcSwqxIcZJdVhlTngEKDOnimpu1uVUTfgEO_fqG3QlO3jkrSxUVivydupw4PQ_F_S_qx2DX3ndtt7BztY4HDm0yzSacrrkl3hs-qvhyphenhyphen0XyL4QH7uvw/s1600/Jadwal+MotoGP+2016+Live+Trans+7+-+1.jpg" /></a></div>
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg6MekwpWhwyXIO_nYI4wFKMKLQND2uLWwpgBtY_xAr61Rnk56C_u_lxuhu6A-b-RO9P5yxg684BG7NnXha6QuqUmTpHCYPHvMwaYNPcrNuAFmuYqyU-rxFsEjbZlM07vbElg3EEzgeX8Q/s1600/Jadwal+MotoGP+2016+Live+Trans+7+-+2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg6MekwpWhwyXIO_nYI4wFKMKLQND2uLWwpgBtY_xAr61Rnk56C_u_lxuhu6A-b-RO9P5yxg684BG7NnXha6QuqUmTpHCYPHvMwaYNPcrNuAFmuYqyU-rxFsEjbZlM07vbElg3EEzgeX8Q/s1600/Jadwal+MotoGP+2016+Live+Trans+7+-+2.jpg" /></a> Demikianlah Jadwal MotoGP 2016 sebagai referensi Anda dalam menyaksikan
siaran-siaran langsung MotoGP yang disiarkan oleh Trans7. <br />
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Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com1tag:blogger.com,1999:blog-4031308222094698665.post-75066159751932810562016-03-01T07:55:00.002-08:002016-08-22T23:07:50.160-07:00galery<div dir="ltr" style="text-align: left;" trbidi="on">
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Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-26783942708708500322016-02-26T03:43:00.001-08:002016-03-17T09:27:34.795-07:00Pengenceran Larutan (Alkohol)<p dir="ltr"><b>D</b>isaat kita akan bekerja terkadang tidak selalu tersedia bahan-bahan yang sesuai keinginan, contoh yang sering ditemukan adalah <b>Alkohol.</b> Dimana kita membutuhkan alkohol dengan konsentrasi tertentu, tetapi yang tersedia hanya alkohol 96%. Tentu kita harus melakukan <b>pengenceran</b> terlebih dahulu untuk mendapatkan suatu konsentrasi yang kita inginkan. Membuat sebuah larutan dengan konsentrasi tertentu, maka kita terlebih dahulu tahu berapa konsentrasi dari bahan murni atau pekatnya. Biasanya kita membuat larutan dengan konsentrasi lebih rendah dari bahan murninya atau yang sering kita sebut dengan pengenceran. Dimana rumus pengenceran yang sama-sama kita ketahui yaitu :</p>
<p dir="ltr"><b>V1.N1 = V2.N2</b></p>
<p dir="ltr">Dengan keterangan :<br>
V1: banyaknya larutan murni yang kita ambilN<br>
N1: konsentrasi larutan yang akan kita encerkan<br>
V2: banyaknya larutan yang akan kita buat dengan pengenceran<br>
N2: konsentrasi larutan yang akan kita buat</p>
<p dir="ltr">Contoh :<br>
Kita membutuhkan Etanol <b>70%</b> sebanyak <b>250ml,</b> sedangkan yang tersedia hanya etanol <b>96%.</b> Maka kita ketahui bahwa Kadar Etanol Murni =96 %  ( N1 )"(terkadang dianggap 100 %atau ABSOLUTE)<br>
Maka perhitungan pembuatan Larutan Etanol 70 % ( N2 )sebanyak250 ml ( V2 )dan (V1) akan kita hitung sebagai berikut :</p>
<p dir="ltr">V1.N1 = V2.N2<br>
V1 = V2.N2 : N1<br>
= 250 ml. 70% : 96 %<br>
= 182,2917 ml ~182,3 ml</p>
<p dir="ltr">Jadi<br>
V1 = 182,3 ml.</p>
<p dir="ltr">☆ Sehingga dapat diketahui cara pembuatan Etanol 70 % yaitu:<br>
- Isi labu ukur 250 ml. dengan aquadest kira-kira setengah dari 68 ml. Karena kalau lebih nanti konsentrasinya kurang dari 70%<br>
- Lalu tambahkan182,3 ml Etanol 96 %( murni /absolute) secara perlahan<br>
- lalu tambahkan aquadest kembali hingga skala menujukkan angka 250 ml atau sampai tanda.</p>
<p dir="ltr">Good Luck.!!</p>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-46690841764291152262016-02-20T09:46:00.001-08:002016-02-20T10:00:56.897-08:00Istilah-Istilah Dalam Dunia MotoGP<p dir="ltr">Berikut ini tersaji daftar kata, terminologi, atau istilah yang biasanya digunakan dalam dunia MotoGP.</p>
<p dir="ltr"><b>Apex</b><br>
Titik paling rapat dari suatu tikungan yang mana biasanya pembalap melaluinya sebelum mulai keluar tikungan dan berakselerasi.</p>
<p dir="ltr"><b>Braking Marker</b><br>
Titik nyata yang digunakan oleh pembalap untuk mengetahui dimana dia harus mulai mengerem saat akan memasuki tikungan. Penanda ini bisa berupa pohon, papan iklan, tanda di trek atau hal lainnya yang bisa dipakai oleh pembalap untuk memandu pola pengereman pembalap.</p>
<p dir="ltr"><b>Chicane</b><br>
Bagian trek yang terdiri dari dua tikungan kearah yang berbeda dan berjarak dekat. Sebuah tikungan ke kiri yang diikuti oleh tikungan ke kanan atau sebaliknya dan seperti huruf S jika dilihat dari udara.</p>
<p dir="ltr"><b>Compounds (Komponen)</b><br>
Jenis karet atau campuran karet yang digunakan sebagai penyusunban.</p>
<p dir="ltr"><b>Curbstones</b><br>
Terletak pada sisi trek atau sesaat setelah tikungan yang digunakan untuk memandu pembalap dan sebagian besar dicat dengan dua warna dan mencolok.</p>
<p dir="ltr"><b>Displacement</b><br>
Kapasitas atau isi silinder mesin motor, biasanya dinyatakan dalam satuan centimeter kubik (cc), contoh 1000cc, 600cc, atau 250cc.</p>
<p dir="ltr"><b>Dry Race</b><br>
Balapan yang dinyatakan kering oleh Race Direction. Pembalap menggunakan banslick.</p>
<p dir="ltr"><b>Endo</b><br>
Juga disebut Stoppie, yaitu trik untuk menghentikan motor dengan cepat sehingga membuat ban belakang terangkat dari aspal. Kebalikan dari wheelie.</p>
<p dir="ltr"><b>Fairing</b><br>
Bagian badan terluar dari motor yang melindungi motor dan pembalap dari debu dan hembusan angin.Fairing didekorasi dengan warna tim, logo sponsor, dan nomor balap.</p>
<p dir="ltr"><b>Gas</b><br>
Istilah lain untuk throttleatau handle akselerasi.</p>
<p dir="ltr"><b>Grid</b><br>
Kumpulan titip start pada trek lurusstart/finishsirkuit, dimana pembalap berkumpul pada permulaan setiap balapan. Berbaris sesuai dengan hasil kualifikasi mereka untuk memulai balapan.</p>
<p dir="ltr"><b>Hairpin</b><br>
Tikungan yang sangat sempit yang harus dilalui dengan lebih perlahan dan biasanya berbentuk U atau V.</p>
<p dir="ltr"><b>High Side</b><br>
Kecelakaan dimana ban belakang motor tergelincir dan kemudian mendapatkan cengkeraman kembali sehingga membuat bagian belakang motor terlempar ke atas setelah mendapatkan grip.</p>
<p dir="ltr"><b>Hole-shot</b><br>
Artinya memimpin balapan sejak tikungan pertama.</p>
<p dir="ltr"><b>Homologation</b><br>
Pengesahan trek dan motor yang digunakan dalam balapan MotoGP merupakan proses perizinan yang dilakukan oleh FIM dan komite yang berhubungan.</p>
<p dir="ltr"><b>Low Side</b><br>
Kecelakaan yang mana salah satu atau kedua ban motor kehilangandaya cengkeram dan tidak bisa kembali mendapatkan traksi yang mengakibatkan motor tergelincir dari bawah pembalap.</p>
<p dir="ltr"><b>Lean Angle (Sudut Tikungan)</b><br>
Adalah sudut kemiringan antara pembalap dengan garis vertikal. Hal ini terjadi saat pembalap merebahkan motornya ke arah trek pada suatu tikungan dengan kecepatan tinggi. Lutut dan siku pembalap sering menyentuh permukaan aspal ketika berada pada sudut tikungan maksimum.</p>
<p dir="ltr"><b>Parc Fermé</b><br>
Area padapit laneyang didesain sebagai tempat parkir pembalap yang naik podium pada setiap kategori dan diwawancarai oleh kru televisi sesaat setelah setiap balapan.</p>
<p dir="ltr"><b>Paddock</b><br>
Area yang berbatasan denganpit-boxyang terletak pada sisi yangberlawanan denganpit lanedimana tim dan pembalap memarkirkan motor home dan peralatan mereka selama Grand Prix.</p>
<p dir="ltr"><b>Pit-box</b><br>
Garasi sementara yang memiliki akses langsung menuju pit lane dan didesain untuk suatu tim yang berpartisipasi pada salah satu dari tiga kelas MotoGP.</p>
<p dir="ltr"><b>Pit Crew</b><br>
Manajemen tim, mekanik, dan asisten mereka.</p>
<p dir="ltr"><b>Pit Lane</b><br>
Lajur akses yang biasanya berbatasan denganmain straightpada sirkuit dan berada di antara pit-box dan sirkuit.</p>
<p dir="ltr"><b>Podium</b><br>
Tempat perayaan kemenangan bagi ketiga pembalap tercepat pertama yang menyelesaikan balapan Grand Prix.</p>
<p dir="ltr"><b>Pole Position</b> atau Pole</p><p dir="ltr">Posisi mulai awal untuk balapan yang diperoleh dengan mencatatkan waktu tercepat pada sesi kualifikasi.</p>
<p dir="ltr"><b>Qualifying (Kualifikasi)</b><br>
Ketiga kelas baik MotoGP, Moto2, maupun Moto3 harus mengikuti kualifikasi satu hari sebelum balapan dimulai. Hasil kualifikasi akan menentukan posisi grid start balapan. Pembalap tercepat akan mendapatkan posisi terdepan dan seterusnya.</p>
<p dir="ltr"><b>Race Direction</b><br>
Tim yang terdiri dari perwakilan dari Dorna, FIM, dan IRTA pada setiap Grand Prix untuk mengambil keputusan seperti menyatakan apakah kondisi balapan kering atau basah.</p>
<p dir="ltr"><b>Ride Through</b><br>
Prosedur penalti dimana pembalap yang melakukan jump start sebelum balapan secara resmi dimulai diminta untuk berkendara melalui jalur pit.</p>
<p dir="ltr"><b>Rookie</b><br>
Pembalap yang berkompetisi pada tahun pertamanya di kelas manapun.</p>
<p dir="ltr"><b>Rostrum</b><br>
Istilah lain untuk podium.</p>
<p dir="ltr"><b>Scrutineering</b><br>
Istilah MotoGP untuk pengecekan dan inspeksi. Scrutineer bertanggung jawab untuk mengecek dan memastikan agar partisipan tidak melanggar peraturan.</p>
<p dir="ltr"><b>Slipstream</b><br>
Adalah mengikuti pembalap lain persis di belakangnya pada trek lurus dan memanfaatkan aliran udara disekitarnya dan motornya dengan membangun momentuk untuk menyalipnya di area yang memiliki tekanan angin yang lebih rendah di belakang pembalap lain tersebut.</p>
<p dir="ltr"><b>Slicks</b><br>
Ban yang tidak memiliki alur, didesain khusus untuk digunakan pada balap jalan raya dan terbuat dari komponen yang lembut sehingga memberikan daya cengkram yang optimal tanpa memperlambat motor.</p>
<p dir="ltr"><b>Swingarm (Lengan Ayun)</b><br>
Bagian belakang motor dimana tempat dipasangnya roda belakang dan bergerak naik turun dengan suspensi belakang.</p>
<p dir="ltr"><b>Tyre Wall (Dinding Ban)</b><br>
Tumpukan ban yang digunakan sebagai perintang tabrakan untuk mengurangi kerusakan dan cidera pada saat terjadi hantaman.</p>
<p dir="ltr"><b>Wet Race (Balapan Basah)</b><br>
Balapan dengan kondisi cuaca yang mempengaruhi permukaan trek diaggap basah, kebalikan dari kering.</p>
<p dir="ltr"><b>Wheelie</b><br>
Akrobat yang biasanya dipertunjukkan oleh pembalap dalam perayaan, dimana ban depan terangkat dari permukaan trek karena akselerasi keras dan melepaskan kopling dengan cepat.</p>
<p dir="ltr"><b>Wild Cards</b><br>
Pembalap nonkontrak yang mengikuti balapan pada saat tertentu saja, berlawanan dengan kompetitor tetap.</p>
<p dir="ltr"><b>Dorna</b><br>
Dorna Sports adalah perusahaan yang mengatur MotoGP.</p>
<p dir="ltr"><b>FIM</b><br>
The Fédération Internationale de Motorcyclisme adalah badan yangmengatur semua olahraga motor di seluruh dunia.</p>
<p dir="ltr"><b>IRTA</b><br>
International Road-Racing Teams Association yang mewakili seluruhtim yang mengikuti ajang Grand Prix.</p>
<p dir="ltr"><b>MSMA</b><br>
Motorcycle Sports Manufacturers’ Association mewakili kepentingan seluruh konstruktor yang terlibat dalam balap motor.</p>
<p dir="ltr"><b>GP (Grand Prix)</b><br>
Event balap yang berlangsung selama tiga hari mencangkup ketiga kelas dalam kejuaraan dunia MotoGP, yaitu kelas MotoGP, Moto2, dan Moto3. GP akhir pekan terdiri dari dua hari latihan dan kualifikasi dan diikuti oleh sesiwarm-updan balapan untuk setiap kelas pada hari terakhir. Saat ini ada 18 balapan GP pada kalender MotoGP.</p>
<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYhjLL9Uv59yBFEaMDqhqlxfwwAzQrIhMTVPHDyGCz4CxuTwuwxg7_Ml8jAjVm4iYxiiD_ereMLMxCUr85KkcA-GtmhHwx0xTbqTSRpwj5dXM7MuE7prSY8bAsiKPzC7Uiqq5W1dlSjQc/s1600/20160221001817.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYhjLL9Uv59yBFEaMDqhqlxfwwAzQrIhMTVPHDyGCz4CxuTwuwxg7_Ml8jAjVm4iYxiiD_ereMLMxCUr85KkcA-GtmhHwx0xTbqTSRpwj5dXM7MuE7prSY8bAsiKPzC7Uiqq5W1dlSjQc/s640/20160221001817.jpg"> </a> </div>Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-17230924447418247342016-02-05T22:32:00.000-08:002016-02-05T22:32:08.280-08:00Asal Mula Candi Prambanan (Cerita seribu candi)<div dir="ltr" style="text-align: left;" trbidi="on">
<small>Di dekat kota Yogyakarta terdapat candi Hindu yang paling indah
di Indonesia. Candiini dibangun dalam abad kesembilan Masehi. Karena
terletak di desa Prambanan, maka candi ini disebut candi Prambanan
tetapi juga terkenal sebagai candi Lara Jonggrang, sebuah nama yang
diambil dari legenda Lara Jonggrang dan Bandung Bondowoso. <br /><img src="http://wahidot.mobie.in/gambar/prambanan1.gif" />
<br />Beginilah ceritanya. Konon tersebutlah seorang raja yang bernama
Prabu Baka. Beliau bertahta di Prambanan. Raja ini seorang raksasa yang
menakutkan dan besar kekuasaannya. Meskipun demikian, kalau sudah
takdir, akhirnya dia kalah juga dengan Raja Pengging. Prabu Baka
meninggal di medan perang. Kemenangan Raja Pengging itu disebabkan
karena bantuan orang kuat yang bernama Bondowoso yang juga terkenal
sebagai Bandung Bondowoso karena dia mempunyai senjata sakti yang
bernama Bandung.
<br /><br />
Dengan persetujuan Raja Pengging, Bandung Bondowoso menempati Istana
Prambanan. Di sini dia terpesona oleh kecantikan Lara Jonggrang, putri
bekas lawannya -- ya, bahkan putri raja yang dibunuhnya. Bagaimanapun
juga, dia akan memperistrinya. <br />
<img src="http://wahidot.mobie.in/gambar/roro-jonggrang.jpg" /> <br />
Lara Jonggrang takut menolak pinangan itu. Namun demikian, dia tidak
akan menerimanya begitu saja. Dia mau kawin dengan Bandung Bondowoso
asalkan syarat-syaratnya dipenuhi. Syaratnya ialah supaya dia dibuatkan
seribu candi dandua sumur yang dalam. Semuanya harus selesai dalam waktu
semalam. Bandung Bondowoso menyanggupinya, meskipun agak keberatan. Dia
minta bantuan ayahnya sendiri, orang sakti yang mempunyai balatentara
roh-roh halus.
<br /><br />
Pada hari yang ditentukan, Bandung Bondowoso beserta pengikutnya dan
roh-roh halus mulai membangun candi yang besar jumlahnya itu. Sangatlah
mengherankan cara dan kecepatan mereka bekerja. Sesudah jam empat pagi
hanya tinggal lima buah candi yang harus disiapkan. Di samping itu
sumurnya pun sudah hampir selesai.
<br /><br />
Seluruh penghuni Istana Prambanan menjadi kebingungan karena mereka
yakin bahwa semua syarat Lara Jonggrang akan terpenuhi. Apa yang harus
diperbuat?
<br /><br />
Segera gadis-gadis dibangunkan dan disuruh menumbuk padi di lesung serta
menaburkan bunga yang harum baunya. Mendengar bunyi lesung dan mencium
bau bunga-bungaan yang harum, roh-roh halus menghentikan pekerjaan
mereka karena mereka kira hari sudah siang. Pembuatan candi kurang
sebuah, tetapi apa hendak dikata, roh halus berhenti mengerjakan
tugasnya dan tanpa bantuan mereka tidak mungkin Bandung Bondowoso
menyelesaikannya. <br />
<img src="http://wahidot.mobie.in/gambar/prambanan3.jpg" /> <br />
Keesokan harinya waktu Bandung Bondowoso mengetahui bahwa usahanya
gagal, bukan main marahnya. Dia mengutuk para gadis di sekitar Prambanan
tidak akan ada orang yang mau memperistri mereka sampai mereka menjadi
perawan tua. Sedangkan Lara Jonggrang sendiri dikutuk menjadi arca.
<br /><br />
Arca tersebut terdapat dalam ruang candi yang besar yang sampai sekarang
dinamai candi Lara Jonggrang. Candi-candi yang ada di dekatnya disebut
Candi Sewu yang artinya seribu. </small></div>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-31192645417388902672016-02-05T22:30:00.001-08:002016-02-05T22:30:42.310-08:00Permusuhan Abadi Valentino Rossi Vs Max Biaggi<div dir="ltr" style="text-align: left;" trbidi="on">
<small><b>Rossi</b> adalah satu dari sekian pembalap motogp yang mampu
meraih sukses luar biasa sejak usia mudanya, dari otobiografienya rossi
bisa mencapai cita-cita diatas cita-cita tertingginya, yaitu sejak kecil
rossi ingin menjadi pembalap sepeda minicross tercepat dunia, tetapi
pada umur 23 Tahun, rossi telah mencapai lebih dari impian tertingginya,
yaitu menjadi juara dunia motogp di berbagai kelas dan menggunakan
pabrikan motor berbeda-beda, pada kelas 125 (aprillia), 250 (aprillia),
500 (honda), MotoGP (honda). <br />
<img src="http://wahidrock.heck.in/files/rb03.jpg" /><br />
Dan mulai tahun 2004 (yamaha), 2005 (yamaha), 2008 (yamaha), 2009
(yamaha), sampai dengan tahun 2005 rossi merupakan pembalap motogp yang
mamapu memepertahankan gelar juara dunia motogp tujuh (7) kali secara
berturut-turut tanpa jedah, dengan pabrikan motor yang berbeda-beda, ini
merupakan salah satu asset rossi yang mebedakan rossi si 46 ( The
Doctor) dengan pembalap yang lainnya yang pernah ada di motogp. Ini
merupakan barometer dominan mengapa rossi sering diberi julukan raja
sirkuit motor dewa motogp. <br /><br />
Max Biagi sebagai musuh bebuyutan rossi dan berseteru hingga 2005 di
kancah motogp pun pada akhirnya pernah melontarkan kata-kata seperti ini
<b>"Rossi mampu membuat motor menjadi kencang, bukan motor yang membuat rossi kencang di lintasan"apa artinya?</b>
<br /><br />
Rossi memiliki kemampuan adaptasi dengan mesin motor sangat baik,
sehingga rossi tahu betul cara memaksimalkan motor di lintasan dengan
setting dan setelan tertentu, sehingga di tangan rossi kurva kecepatan
dan laju motor bisa compatible dengan kondisiaspal dan cuaca maupun suhu
sirkuit, terutama sebelum motogp didominasi oleh perangkat dan piranti
elektronik. Sehingga motor benar-benar kencang dengan maksimal sesuai
dengan kondisi motor dan konfigurasi mesin saat itu. Mengapa biagi
berkata demikian?
<br /><br />
Pada saat 2004 rossi pindah ke Yamaha, biagi pernah berkelakar dan
mengancam rossi, bahwa dengan memutuskan pindah ke Yamaha dan honda,
akan membuat rossi tidak bisa tersenyum lagi diatas podium tertinggi
motogp, dan pada saat itu biagi pindah dari Camel Yamahake Honda tim
pabrikan utama, dan biagi berjanji dengan entengnya akan menghabisi
rossi di lintasan balap motogp, Lalu bagaimana kenyataannya? <br />
<img src="http://wahidrock.heck.in/files/rb04.jpg" /> <br />
Pada kenyataannya terbalik, dengan berbagai segudang pengalaman dan
teknik menguasai sirkuit baik didalam dandiluar arena sirkuit motor,
justru rossilah yang paling piawai menutup racing line honda yang
ditunggangi biagi, sehingga kecepatan motor honda yang sangat ditakuti
itu bisa dibungkam oleh rossi yang saat itu menunggangi sadelyamaha, dan
ini terjadi berturut-turut hingga tahun 2005 motogp, dan rossilah yang
tetap memegang gelar juara dunianya bersama Yamaha. Dan ini lah salah
satu dari beberapa teknis penting di sirkuit lintasan motogp yang
akhirnya membuat biagi benar-benar mengakui ketajaman dan skill seorang
rossi di lintasan motogp, dan membuatnya memberikan komentar " rossi
bisa membuat motor kenacang, bukan motor yang membuatnya kencang", apa
dampaknya bagi biagi sendiri dengan kekalahannya ini? <br />
<img src="http://wahidrock.heck.in/files/juarawelcom04.jpg" /> <br />
Yah, pada tahun 2006 biagi dikeluarkan dari honda karena tidak menepati
janjinya bahwa biagi bisa menghabisi rossi dan memegang gelar juara
dunia, asalkan diberi motor kencang milik honda yang pernah ditunggangi
rossi, dalam keadaan inipun biagi masih bisa berkomentar, bahwa "Motor
honda yang sekarang tidak sekencang yang ditunggangi rossi", dan
pabrikan honda tetap pada keputusannya untuk mengeluarkan biagi karena
kenyataannya berkata lain, dan pada tahun 2006 biagi tidak mendapatkan
satupun sponsor untuk bisa mengikuti balap motogp, yang merupakan salah
satu dari sekian syarat ketat, yaitu pembalap sebagus dan berkelas apa
saja, jika tidak memiliki sponsor yang kuat maka pembalap tersebut tidak
bisa masuk dalam gelaran kejuaraan motogp.
<br /><img src="http://wahidrock.heck.in/files/rossi04.jpg" /><br />
Sebaliknya untuk rossi, setelah musim 2005 berakhir, semakin kuatlah
rossi sebagai raja motogp, semakin banyak penggemarnya, karena rossi
tidak pernah sombong baik didalam dan diluar lintasan, rossi lebih
senang dengan menyimpan kekuatan tersembunyi dari pada memberitahukannya
kepada yang lainnya, rossi dan yamaha pun semakin kebanjiran sponsor,
karena dari dahulu, rossi adalah magnet penonton di sirkuit motogp
manapun, dimanapun motogp digelar, siapapun juaranya,rossi tetap jadi
pusat magnet perhatian penggemarnya. Sampai dengan tahun 2005 rossi
sering melakukan manuver-manuver aneh dan beresiko tinggi, yaitu
menuntaskan balapan dan mengalahkan lawan pada lap-lap terakhir, ini
jelas-jelas pertunjukan yang beresiko, tetapi buat rossi motogp seperti
sinetron katanya : <br />
Bagaimana caranya memacu adrenalin dan detak penonton pada akhir-akhir lap, anda semua pasti ingat pada saat Jerez 2005,<br /><img src="http://wahidot.mobie.in/gambar/rossi-gibernau-jerez-2005.jpg" /><br /> pakisa 2005, mugello 2005, Philips island 2005.<br /><img src="http://wahidot.mobie.in/gambar/rossi01.jpg" /><br />semua
adalah ciri khas pertunjukan rossi diatas lintasan balap motogp, salah
satu kemampuan yang sangat langka dimiliki pembalap lainnya, yang
menjadikanmotogp bukan arena pertarungan kencang-kencangan, tapi menjadi
tontonan yang menarik dengan banyak estetika seni balap dan keindahan
lekak lekuk sirkuit balap motogp. <br /><br />
<b>Sumber : </b><a href="http://mcscv.com/">www.mcscv.com</a></small></div>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-65830707672207955222016-02-05T22:28:00.000-08:002016-02-05T22:28:23.103-08:00Sangkuriang ( Legenda Gunung Tangkuban Perahu)<div dir="ltr" style="text-align: left;" trbidi="on">
<small>Pada jaman dahulu, tersebutlah kisah seorang puteri raja di Jawa
Barat bernama Dayang Sumbi. Ia mempunyai seorang anak laki-laki yang
diberi nama Sangkuriang. Anaktersebut sangat gemar berburu Ia berburu
dengan ditemani oleh Tumang, anjing kesayangan istana. Sangkuriang tidak
tahu, bahwa anjing itu adalah titisan dewa dan juga bapaknya. <img src="http://wahidot.mobie.in/gambar/sangkuriang.jpg" />
<br />Pada suatu hari Tumang tidak mau mengikuti perintahnya untuk
mengejar hewan buruan. Maka anjing tersebut diusirnya ke dalam hutan.
Ketika kembali ke istana, Sangkuriang menceritakan kejadian itu pada
ibunya. Bukan main marahnya Dayang Sumbi begitu mendengarcerita itu.
Tanpa sengaja ia memukul kepala Sangkuriang dengan sendok nasi yang
dipegangnya. Sangkuriang terluka. Ia sangat kecewa dan pergi mengembara.<br />
Setelah kejadian itu, Dayang Sumbi sangat menyesali dirinya. Ia selalu
berdoa dan sangat tekun bertapa. Pada suatu ketika, para dewa memberinya
sebuah hadiah. Ia akanselamanya muda dan memiliki kecantikan abadi.
Setelah bertahun-tahun mengembara, Sangkuriang akhirnya berniatuntuk
kembali ke tanah airnya. Sesampainya disana, kerajaan itu sudah berubah
total. Disana dijumpainya seorang gadis jelita, yang tak lain adalah
Dayang Sumbi<br />
Terpesona oleh kecantikan wanita tersebut maka, Sangkuriang melamarnya.
Oleh karena pemuda itu sangat tampan, Dayang Sumbi pun sangat terpesona
padanya.Padasuatu hari Sangkuriang minta pamit untuk berburu. Ia minta
tolong Dayang Sumbi untuk merapikan ikat kepalanya. Alangkah terkejutnya
Dayang Sumbi ketika melihat bekas luka di kepala calon suaminya. <br />Luka
itu persis seperti luka anaknya yang telah pergi merantau. Setelah lama
diperhatikannya, ternyata wajah pemuda itu sangat mirip dengan wajah
anaknya. Ia menjadi sangat ketakutan.Maka kemudian ia mencari daya upaya
untuk menggagalkanproses peminangan itu. Ia mengajukan dua buah syarat.
Pertama, ia meminta pemuda itu untuk membendung sungai Citarum. Dan
kedua, ia minta Sangkuriang untuk membuat sebuah sampan besar untuk
menyeberang sungai itu. Kedua syarat itu harus sudah dipenuhi sebelum
fajar menyingsing. <br />Malam itu Sangkuriang melakukan tapa. Dengan
kesaktiannya ia mengerahkan mahluk-mahluk gaib untuk membantu
menyelesaikan pekerjaan itu. Dayang Sumbi pun diam-diam mengintip
pekerjaan tersebut. Begitu pekerjaan itu hampir selesai, Dayang Sumbi
memerintahkan pasukannya untuk menggelar kain sutra merah di sebelah
timur kota. Ketika menyaksikan warna memerah di timur kota, Sangkuriang
mengira hari sudah menjelangpagi. Ia pun menghentikan pekerjaannya. Ia
sangat marah oleh karena ituberarti ia tidak dapat memenuhi syarat yang
diminta Dayang Sumbi. <br />Dengan kekuatannya, ia menjebol bendungan yang
dibuatnya. Terjadilah banjir besar melanda seluruh kota. Iapun kemudian
menendang sampan besar yang dibuatnya. Sampan itu melayang dan jatuh
menjadi sebuah gunung yang bernama"Tangkuban Perahu." <img src="http://wahidot.mobie.in/gambar/Cerita-Gunung-Tangkuban-Perahu.jpg" /> <br />TAMAT.</small></div>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-78727056150128625992016-02-05T22:26:00.002-08:002016-02-05T22:26:39.239-08:00Fenomena Lautan Menurut Al Qur`an dan Sains<div dir="ltr" style="text-align: left;" trbidi="on">
<small>Maha Besar Alloh dengan sengala kekuasaanya atas ciptaanya alam
semesta yang menakjupkan ini. Kadang tidak terfikir oleh kita bahwa
ciptaanya sungguh luar biasa, bahkan nalar kita pun sulit untuk
menjangkaunya namun dapat dibuktikan dengan ilmiah. <br /><br />Al Qur'an
yang diturunkan berabad-abad tahun yang lalu sudah menceritakan hal ini,
namun baru dapat dibuktikan dan dijelaskan secara ilmiah baru-baru ini.
Dan berikut penjabaranya dalam islam dan sains.<br /><br /><b>☆ Dasar laut yang gelap</b><br /><img src="http://wahidot.mobie.in/gambar/5.jpg" /><br /> Manusia tidak mampu menyelam di laut dengan kedalaman di bawah 40 meter tanpa peralatan khusus. <br /><br />Dalam
sebuah buku berjudul Oceans juga dijelaskan, pada kedalaman 200 meter
hampir tidak dijumpai cahaya, sedangkan pada kedalaman 1000 meter
tidak terdapat cahaya sama sekali. <br /><br />Kondisi dasar laut yang gelap
baru bisa diketahui setelah penemuan teknologi canggih. Namun Alquran
telah menjelaskan keadaan dasar lautan semenjak ribuan tahun lalu
sebelum teknologi itu ditemukan.<br /><br />Alquran surat An Nur ayat 40 menjelaskan mengenai fakta ilmiah ini.<span style="color: #fe8f17;"><b>"Atau
seperti gelap gulita di lautan yang dalam, yang diliputi oleh ombak,
yang di atasnya ombak (pula), di atasnya (lagi) awan; gelap gulita yang
tindih-bertindih, apabila dia mengeluarkan tangannya, tiadalah dia dapat
melihatnya, (dan) barang siapa yang tiada diberi cahaya (petunjuk) oleh
Allah tiadalah dia mempunyai cahaya sedikit pun.”(QS An Nuur: 40).</b></span><br /><br /><b>☆ Sungai dibawah laut</b><br /> <img src="http://wahidot.mobie.in/gambar/6.jpg" /> <br />Maha
Suci Allah yang Maha Menciptakan Sungai dalam Laut “Akan Kami
perlihatkan secepatnya kepada mereka kelak, bukti-bukti kebenaran Kami
di segenap penjuru dunia ini dan pada diri mereka sendiri, sampai terang
kepada mereka, bahwa al-Quran ini suatu kebenaran. <br /><br />Belumkah cukup bahwa Tuhan engkau itu menyaksikan segala sesuatu. ” (QS Fushshilat : 53) <span style="color: #fe8f17;"><b>“Dan
Dialah yang membiarkan dua laut mengalir (berdampingan) ; yang ini
tawar lagi segar dan yang lain masin lagi pahit; dan Dia jadikan antara
keduanya dinding dan batas yang menghalangi.” (Q.S Al Furqan:53)</b></span><br /><br />Jika Anda termasuk orang yang gemar menonton rancangan TV `Discovery’ pasti kenal <span style="color: #d20000;">Mr.Jacques Yves Costeau,</span> ia seorang ahli oceanografer dan ahli selam terkemuka dari Perancis. <br /><br />Orang
tua yang berambut putih ini sepanjang hidupnya menyelam ke berbagai
dasar samudera di seantero dunia dan membuat filem dokumentari tentang
keindahan alam dasar laut untuk ditonton di seluruh dunia. <br /><br />Pada
suatu hari ketika sedang melakukan eksplorasi di bawah laut, tiba-tiba
ia menemui beberapa kumpulan mata air tawar-segar yang sangat sedap
rasanya kerana tidak bercampur/tidak melebur dengan air laut yang masin
di sekelilingnya, seolah-olah ada dinding atau membran yang membatasi
keduanya. <br /><br />Fenomena ganjil itu memeningkan Mr. Costeau dan
mendorongnya untuk mencari penyebab terpisahnya air tawar dari air masin
di tengah-tengah lautan. <br /><br />Ia mulai berfikir, jangan-jangan itu
hanya halusinansi atau khalayan sewaktu menyelam. Waktu pun terus
berlalu setelah kejadian tersebut, namun ia tak kunjung mendapatkan
jawapan yang memuaskan tentang fenomena ganjil tersebut. <br /><br />Sampai
pada suatu hari ia bertemu dengan seorang profesor Muslim, kemudian ia
pun menceritakan fenomena ganjil itu. Profesor itu teringat pada ayat Al
Quran tentang bertemunya dua lautan ( surat Ar-Rahman ayat 19-20) yang
sering diidentikkan dengan Terusan Suez. <br /><br />Ayat itu berbunyi <span style="color: #fe8f17;"><b>
“Marajal bahraini yaltaqiyaan, bainahumaa barzakhun laa yabghiyaan..
.”Artinya: “Dia biarkan dua lautan bertemu, di antara keduanya ada batas
yang tidak boleh ditembus.” </b></span>Kemudian dibacakan surat Al Furqan ayat 53 di atas. <br /><br />Selain
itu, dalam beberapa kitab tafsir, ayat tentang bertemunya dua lautan
tapi tak bercampur airnya diartikan sebagai lokasi muara sungai, di mana
terjadi pertemuan antara air tawar dari sungai dan air masin dari laut.
<br /><br />Namun tafsir itu tidak menjelaskan ayat berikutnya dari surat
Ar-Rahman ayat 22 yang berbunyi “Yakhruju minhuma lu’lu`u wal marjaan”
artinya “Keluar dari keduanya mutiara dan marjan.” Padahal di muara
sungai tidak ditemukan mutiara. <br /><br />Terpesonalah Mr. Costeau
mendengar ayat-ayat Al Qur’an itu, melebihi kekagumannya melihat
keajaiban pemandangan yang pernah dilihatnya di lautan yang dalam. <br /><br />Al
Qur’an ini mustahil disusun oleh Muhammad yang hidup di abad ke tujuh,
suatu zaman saat belum ada peralatan selam yang canggih untuk mencapai
lokasi yang jauh terpencil di kedalaman samudera. <br /><br /> Benar-benar
suatu mukjizat, berita tentang fenomena ganjil 14 abad yang silam
akhirnya terbukti pada abad 20. Mr. Costeau pun berkata bahwa Al Qur’an
memang sesungguhnya kitab suci yang berisi firman Allah, yang seluruh
kandungannya mutlak benar. Dengan seketika dia pun memeluk Islam. <br /><br /><b>☆ Api didasar laut</b><br /> <img src="http://wahidot.mobie.in/gambar/7.jpg" /> <br />"(1)
Demi bukit (Sinai), (2) dan kitab yang ditulis (3) pada lembaran
terbuka, (4) Demi Baitul Ma’mur (ka’bah), (5) atap yang ditinggikan
(langit), (6) dan laut yang di dalam dasarnya ada api.”(QS. Ath-Thuur
[52]: 1-6). <br /><br />Klausa sajara at-tannur secara bahasa berarti
‘menyalakan api hingga panas’. Sejak diturunkannya Al-Qur’an hingga
berabad-abad setelah itu, orang-orang arab belum mampu menguak fakta
bagaimana di balik dasar laut terdapat api, sedangkan air dan panas
adalah sesuatu yang berlawanan. <br /><br />Hingga baru-baru ini di temukan
bahwa bumi yang kita huni ini memiliki lapisan batu bagian luar yang
terbelah menjadi beberapa lempengan yang terhampar hingga mencapai
ratusan kilometer persegi. <br /><br />Kedalaman berkisar antara 65 hingga
150 km. yang mengherankan adalah lempengan-lempengan ini saling terkait
antara satu dengan yang lainnya, sehingga menjadikannya seolah-olah
seperti satu lempengan saja. Allah SWT pernah bersumpah dalam salah satu
ayat berikut: <span style="color: #fe8f17;"><b>“Dan demi bumi yang mempunyai belahan.”(QS. Ath-Thoriq [86]: 12). </b></span> <br /><br />Ini
adalah ungkapan yang menjelaskan bahwa di bawah permukaan bumi terdapat
hamparan lempengan-lempengan yang berhubungan satu sama lain, sehingga
menjadikannya seperti satu lempengan. <br /><br />Dalam ayat ini, jelas
sekali kemukjizatan dan keistimewaan Al-Qur’an, Allah SWT bersumpah demi
belahan (lempengan) –yang merupakan kesatuan dari beberapa lempengan
bumi- para ilmuan menyamakannya seperti daging yang berbentuk bola
tenis. <br /><br />Lempengan-lempengan ini terletak di lembah atau dasar
samudra. Ia menahan lelehan bebatuan panas yang dapat membuat laut
meluap-luap. Akan tetapi banyaknya air di lautan dapat meredam panasnya
bara yang memiliki suhu panas tinggi ini lebih dari 10000 Cº mampu
menguapkan air laut. Ini adalah salah satu di antara banyak fakta-fakta
bumi lainnya yang mengejutkan para ilmuan. <br /><br />Dua orang ilmuawan Rusia, <span style="color: #d20000;">Anatho Sjabaftisy, ahli Geologi,dan Yuri Bejdenhov, ahli Biologi dan Geologi, </span>bersama dengan seorang ilmuwan Amerika,<span style="color: #d 20000;"> Rona Clant,</span> mengadakan penyelaman di dekat salah satu lempeng terpenting di dunia.
<br /><br />Mereka menyelam dengan menggunakan kapal selam modern Mira
hingga sampai pada titik tujuan berjarak 175 km dari pantai Miami.
Mereka menyelam hingga kedalaman 2 mil dari permukaan air laut, sehingga
sampai pada lahar di dalam laut. Tidak ada yang memisahkan mereka dari
lahar tersebut kecuali sebuah lubang dari Akrelik. Saat itu suhu
mencapai 2310 Cº dan mereka berada pada tepi bebatuan jurang, yang
dibawahnya memancar air mata menyala-nyala.<br /><br />Di sana merupakan
pangkal bumi di lembah dalam samudra. Mereka benar-benar menyaksikan
bahwa air dingin yang terdapat di permukaan laut bergerak menuju ke
bawah. <br /><br />Pada kedalaman satu mil di bawah laut, lahar letusan
gunung berapi semakin dekat dan meleleh keluar dan memanas, hingga
kemudian menyemburkan abu-abu vulkanik dan zat-zat tambang yang amat
panas. Para ilmuan telah menegaskan bahwa hal seperti ini trejadi di
seluruh lautan dan samudra. Kadang sering terjadi di satutempat, tetapi
pada tempat yang lainnya jarang terjadi. <br /><br /> Gunung-gunung berapi
di dasar samudra jumlahnya lebih banyak dan lebih aktif dibandingkan
dengan gunung-gunung berapi di atas daratan. Gunung-gunung berapi
tersebut terbentang sepanjang dasar samudra. <br /><br />Keajaiban yang
terdapat pada frasa al-bahru al-masjur adalah bahwa dengan tidak adanya
oksigen di dasar lautan, tidak memungkinkan bagi lahar vulkanik
menyeruakmelewati lempengan di dasar samudra dan mencapai ketinggian
garis lempengan tersebut. <br /><br />Selain itu, lahar vulkanik biasanya
berwarna kehitam-hitaman, sangat panas, dan tidak langsung bergejolak.
Lempengan di dasar lautan menyerupai tempat pembakaran roti. Jika
dipanaskan di bawahnya dengan suatu bahan bakar, maka ia akan memanas
dengan suhu tinggi, sehingga roti bisa matang di atasnya.<br /><br /> Inilah
yang dimaksud secara bahasa pada kata masjur. Tidak ada satu katapun
yang tepat untuk menggantikan makna kata tersebut secara tepat, agar
kita bisa merenungi keagungan ciptaan Allah SWT.
<br /><br /><b>☆ Lautan yang tidak bercampur satu sama yang lainya</b><br /> <img src="http://wahidot.mobie.in/gambar/8.jpg" /><br /><br />Salah satu di antara sekian sifat lautan yang baru-baru ini ditemukan adalah berkaitan dengan ayat Al Qur’an sebagai berikut: <span style="color: #fe8f17;"><b>“Dia
membiarkan dua lautan mengalir yang keduanya kemudian bertemu, antara
keduanya ada batas yang tak dapat dilampaui oleh masing-masing.”(QS. Ar
Rahman:19-20)</b></span> <br /><br />Sifat lautan yang saling bertemu, akan
tetapi tidak bercampur satu sama lain ini telah ditemukan oleh para ahli
kelautan baru-baru ini. Dikarenakan gaya fisika yang dinamakan
“tegangan permukaan”, air dari laut-laut yang saling bersebelahan tidak
menyatu.<br /><br />Akibat adanya perbedaan masa jenis, tegangan permukaan
mencegah lautan dari bercampur satu sama lain, seolah terdapat dinding
tipis yang memisahkan mereka. <span style="color: #d20000;">(Davis, Richard A., Jr. 1972, Principles of Oceanography, Don Mills, Ontario, Addison-Wesley Publishing, s. 92-93.)</span><br /><br />Terdapat
gelombang besar, arus kuat, dan gelombang pasang di Laut Tengah dan
Samudra Atlantik. Air Laut Tengah memasuki Samudra Atlantik melalui
selat Jibraltar. <br /><br />Namun suhu, kadar garam, dan kerapatan air laut
di keduatempat ini tidak berubah karena adanya penghalang yang
memisahkan keduanya. <br /><br />Sisi menarik dari hal ini adalah bahwa pada
masa ketika manusia tidak memiliki pengetahuan apapun mengenai fisika,
tegangan permukaan, ataupun ilmu kelautan, hal ini dinyatakan dalam Al
Qur’an.<br /><br />Sumber : <a href="http://mujahidah213.blogspot.in/2015/03/fakta-ilmiah-kebenaran-al-quran-dalam.html">Mujahidah</a></small></div>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-23884860663815927082016-02-05T22:24:00.001-08:002016-02-05T22:24:09.966-08:00Penggolongan obat Narkotik Dan Psikotropik<div dir="ltr" style="text-align: left;" trbidi="on">
<small>Tahukah Anda penggolongan obat narkotika dan psikotropika itu ada
berapa macam, dan bagaimana penggunaan yang sebenarnya? Baiklah mari
kita membaca<img src="http://wahidot.mobie.in/images/aneh.gif" /><br />
<b>☆ Narkotika</b><br />
Logo narkotika seperti tanda (+)<img src="http://wahidot.mobie.in/gambar/narkotik.jpeg" /><br />
Menurut UU Narkotika No 35 Tahun 2009, narkotika di definisikan sebagai
zat atau obat yang berasal dari tanaman atau bukan tanaman, baik
sintetis maupun semisintetis, yang dapat menyebabkan <span style="color: #d20000;">penurunan
atau perubahan kesadaran, hilangnya rasa, mengurangi sampai
menghilangkan rasa nyeri, dan dapat menimbulkan ketergantungan.</span><br />
Obat Narkotik bersifat adiksi atau suatu kondisi ketergantungan fisik
dan mental terhadap hal-hal tertentu yang menimbulkan perubahan perilaku
bagi orang yang mengalaminya. Penggunaan narkotik diawasi dengan ketat,
sehingga obat golongan narkotik hanya dapatdiperoleh dengan resep
dokter yang asli (tidak dapat menggunakan kopi resep). <br />
Dalam UU No 35 Tahun 2009, narkotika digolongkan kedalam tiga golongan : <br /><br />
☆ Narkotika Golongan I <br />
Narkotika golongan satu hanya dapat digunakan untuk tujuan pengembangan
ilmu pengetahuan dan tidak digunakan dalam terapi, serta mempunyai
potensi sangat tinggi mengakibatkan ketergantungan <br />
Contoh : <span style="color: #d20000;">Heroin, Kokain, Daun Kokain, Opium, Ganja, Jicing, Katinon, MDMDA/Ecstasy, </span>dan lebih dari 65 macam jenis lainnya.<br /> <br />
☆ Narkotika Golongan II <br />
Narkotika golongan dua, berkhasiat untuk pengobatan digunakan sebagai
pilihan terakhir dan dapat digunakan dalam terapi dan/atau untuk tujuan
pengembangan ilmu pengetahuan serta mempunyai potensi tinggi
mengakibatkan ketergantungan. <br />
Contoh : <span style="color: #d20000;">Morfin, Petidin, Fentanil, Metadon, Dll.</span><br /><br />☆ Narkotika golongan III <br />
Narkotika golongan tiga adalah narkotika yang memiliki daya adiktif
ringan, tetapi bermanfaat dan berkhasiat untuk pengobatan dan
penelitian. Golongan 3 narkotika ini banyak digunakan dalam terapi
dan/atau untuk tujuan pengembangan ilmu pengetahuan serta mempunyai
potensi ringan mengakibatkan ketergantungan <br />
Contoh : <span style="color: #d20000;">Codein, Buprenorfin, Etilmorfina, Kodeina, Nikokodina, Polkodina, Propiram, </span>dan ada 13 (tiga belas) macam termasuk beberapa campuran lainnya. <br /><br />
<b>☆ Psikotropika</b><br />Logo obat psikotropik berbentuk huruf K dengan lingkaran merah
<img src="http://wahidot.mobie.in/gambar/obatkeras.jpg" /> <br />
Obat Psikotropika merupakan Zat atau obat baik ilmiah atau sintesis, bukan narkotika <span style="color: #d20000;">yang
berkhasiat psikoaktif melalui pengaruh selektif pada susunan saraf
pusat yang menyebabkan perubahan khas pada aktivitas mental dan prilaku.
</span><br />
Psikotropika digolongkan menjadi 4 golongan : <br />☆ Golongan I <br />
1. Hanya untuk tujuan pengembangan ilmu pengetahuan <br />
2. Tidak digunakan dalam terapi <br />
3.Potensi sindrom ketergantungan amat kuat <br />
Contoh : <span style="color: #d20000;">LSD, Eticylidine, Etrytamine, Parahexyl </span><br /> <br />
☆ Golongan II <br />
1. Untuk pengobatan <br />
2. Untuk pengembangan ilmu pengetahuan <br />
3. Potensi sindrom ketergantungan kuat <br />
Contoh : <span style="color: #d20000;">Amphetamine, Dexamphetamine, Fenetylline, Metamfetamin (shabu), Sekobarbital, Zipeprol.</span><br /> <br />
☆ Golongan III <br />
1. Untuk pengobatan atau terapi <br />
2. Untuk pengembangan ilmu pengetahuan <br />
3. Potensi sindrom ketergantungan sedang <br />
Contoh : <span style="color: #d20000;">amobarbital, cathine, cyclobarbital, funitrazepam, pentazosine.</span> <br /> <br />
☆ Golongan IV <br />
1. Untuk pengobatan atau terapi <br />
2. Untuk pengembangan ilmu pengetahuan <br />
3. Potensi sindrom ketergantungan ringan <br />
Contoh : <span style="color: #d20000;">allobarbital, alprazolam, aminorex,
diazepam, halozepam, triazolam, klobazam, fenobarbital, barbital,
klorazepam, klordiazepoxide dan nitrazepam ( Nipam,pil BK/koplo, DUM,
MG, Lexo, Rohyp )</span><br />Itulah penggolongan obat narkotik dan
psikotropik, ingat jangan salah gunakan obat dan gunakan obat secara
bijak karena pada dasarnya obat adalah Racun.<img src="http://wahidot.mobie.in/images/sip.gif" />Semoga bermanfaat <br /><br />
Sumber: UU Narkotika </small></div>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-85215036271383248782016-02-05T22:15:00.001-08:002016-02-06T09:37:56.094-08:00Tidak semua obat dapat diminum sesudah makan, kenali konsumsi obat sebelum atau sesudah makan?<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<small><img src="http://wahidot.mobie.in/gambar/minumobat.jpg" />Kebiasaan minum obat yang dikenal masyarakat kita adalah sebelum
minum obat sebaiknya perut diisi terlebih dahulu walau hanya sedikit.
Alasannya, biar ada tenaga.<br /><br />Kebiasaan yang sepertinya sudah dianggap sebagai kebenaran ini sesungguhnya tidak tepat <span style="color: #d20000;">Tidak semua jenis obat diminum setelah/sesudah makan,</span> bahkan beberapa jenis obat justru harus diminum pada waktu perut kosong atau sebelum makan. <br /><br />Kita perlu mengetahui kapan saat yang tepat untuk minum obat. Secara umum, obat berdasarkan kerjanya dibagi atas <span style="color: #fe8f17;">obat lokal</span> dan <span style="color: #fe8f17;">obat sistemik</span> <br /><br />Obat lokal contohnya <span style="color: green;"> antasid </span>yang kerjanya menetralkan asam lambung di lambung, atau obat cacing yang kerjanya di usus. <br /><br />Obat jenis ini tidak mengalami proses penyerapan (absorpsi) sehingga tidak sampai di darah. <br /><br />
Sementara obat sistemik, harus sampai di darah dalam jumlah yang cukup
sehingga proses absorpsi merupakan faktor yang sangat menentukan
kualitas efek yang dihasilkan. <br /><br /> <br /><b>Cara obat diserap tubuh </b><br />
Begitu obat kita minum, maka obat akan memulai perjalanan panjangnya dalam tubuh dalam beberapa kondisi. <br /><br />Jika
bentuk sediaan/atau bentuk obat yang diminum berupa sediaan padat
seperti tablet maka dia akan hancur lebih dahulu kemudian baru
melepaskan zat aktif dalam bentuk partikel halus. <br /><br />Partikel halus
ini akan melarut dengan cairan tubuh, di lambung atau di usus,
tergantung dari sifat fisikokimia obat, dan seterusnya akan diabsorpsi
sehingga sampai di darah. <br /><br />Jika obat yang diminum dalam bentuk
cair yang terlarut seperti sirup, maka obat langsung mengalami proses
absorpsi. Umumnya obat diabsorpsi di usus halus karena permukaannya
sangat luas. Hanya sebagian kecil obat yang diabsorpsi di lambung. <br /><br /> <br /><b>Interaksi makanan dengan obat </b><br />Cepat atau lambatnya proses absorpsi banyak dipengaruhi oleh berbagai faktor, salah satunya adalah faktor adanya makanan. <br /><br />Adanya makanan dapat menimbulkan interaksi dengan obat. Akibat interaksi ini adalah: <br /> <span style="color: #fe8f17;">
☆ ada obat-obat yang absorpsinya terganggu dengan adanya makanan, <br />
☆ ada yang terbantu dengan adanya makanan, <br />
☆ ada yang tidak terpengaruh oleh ada atau tidak adanya makanan.</span><br /><br />Keadaan seperti inilah yang menjadi sebab kenapa obat harus diminum sebelum makan atau malah diminum setelah makan. <br /><br /> <br /><b>Berapa jam sebelum dan sesudah makan </b><br /> <span style="color: #fe8f17;">Pertanyaan selanjutnya, kapan yang disebut “sebelum makan” atau “sesudah makan” itu?</span><br /> <img src="http://wahidot.mobie.in/gambar/1114.jpg" /><br />Sebelum
makan adalah: ketika perut dalam keadaan kosong yaitu 2 jam setelah
makan terakhir sampai 1 jam menjelang makan berikutnya. <br /><br />Contoh obat yang dikonsumsi sebelum makan: <span style="color: #d20000;"> gol obat lambung, obat anti mual, antibiotika eritromisin dan amoksisilin, dan analgetika parasetamol.</span> Obat-obat ini akan diabsorpsi lebih baik jika tidak ada makanan, sehingga lebih baik jika diminum sebelum makan. <br /><br />Sesudah makan adalah: sesaat sesudah makan, ketika perut masih berisi makanan, jangan lewat dari 2 jam. <br /><br />Kalau
lebih dari dua jam setelah makan, makanan sudah diolah dan diserap,
sehingga kondisinya bisa disamakan dengan sebelum makan. <br /><br />Contoh obat yang dikonsumsi setelah makan: <span style="color: #d20000;"> obat antiepilepsi fenitoin,</span> atau <span style="color: #d20000;">obat antihipertensi propanolol </span>misalnya, akan terbantu absorpsinya dengan adanya makanan, sehingga sebaiknya diminum sesudah makan. <br /><br />
<br /><b>Interaksi obat dengan kandungan tertentu dalam makanan, obat lain, suplemen</b><br />Selain
interaksi dengan makanan secara umum, obat tertentu dapat berinteraksi
secara khusus dengan senyawa tertentu dari makanan. <br /><br />Contoh terkenal adalah antibiotika <span style="color: #d20000;">Tetrasiklin</span>.
Tetrasiklin dapat berikatan dengan senyawa kalsium, dan membentuk
senyawa yang tidak dapat diserap oleh tubuh, sehingga mengurangi efek
tetrasiklin. <br /><br />Jadi jika tetrasiklin diminum bersama susu, atau
suplemen vitamin-mineral yang mengandung kalsium, efek tetrasiklin bisa
berkurang. <br /><br />Selain tetrasiklin, ada juga antibiotika golongan kuinolon, seperti <span style="color: #fe8f17;">siprofloksasin, ofloksasin,</span> yang juga bisa mengikat logam-logam bervalensi dua atau tiga, seperti kalsium, magnesium, dan aluminium. <br /><br />Karena
itu, sebaiknya tidak minum obat ini bersama-sama dengan obat-obat yang
mengandung logam-logam tersebut, misalnya obat maag seperti <span style="color: green;">antasid</span> yang mengandung logam magnesium dan aluminium. <br /><br />Jika
terpaksa harus menggunakan obat maag (antasid) bersamaan dengan
antibiotika tetrasiklin atau golongan kuinolon, sebaiknya diberi selang
waktu sedikitnya 2 jam. <br /><br />Selain interaksinya dengan makanan, sifat suatu obat juga menentukan kapan sebaiknya obat diminum. <br /><br />Beberapa
obat tertentu dapat mengiritasi mukosa lambung sehingga dapat
menyebabkan luka pada lambung, atau malah memperparah tukak lambung itu
sendiri (sakit maag). <br /><br />Contoh terkenal obat yang termasuk golongan ini adalah <span style="color: #fe8f17;">asetosal, kortikosteroid (seperti deksametason dan hidrokortison) dan obat-obat antiradang seperti diklofenak, piroksikam, </span>dan lain-lain yang sering digunakan untuk obat rematik. <br /><br />Obat-obat ini harus diminum sesudah makan. <br /><br /><br />Sumber : Syofyan, S.Si., M.Farm, Apt. Fakultas Farmasi Universitas Andalas </small></div>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-34370258977286299422013-01-22T09:50:00.004-08:002013-01-22T10:03:12.718-08:00JADWAL LENGKAP ISL AREMA<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Times New Roman","serif";">Jaddwal terlengkap indonesia super league ISL musim 2013</span><br />
<b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bulan :
Januari 2013</span></b><br />
<span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">
- 05/01/2013 : SRIWIJAYA vs FC PERSIBA BALIKPAPAN (Stadion Gelora Sriwijaya,
Jakabaring)<br />
- 05/01/2013 : PELITA JAYA vs PS BARITO (Stadion Siliwangi)<br />
- 06/01/2013 : PERSIJA vs PERSISAM (Stadion Utama Gelora Bung Karno)<br />
- 06/01/2013 : PSPS vs MITRA KUKAR (Stadion Kuantan Singingi Sport Center)<br />
- 08/01/2013 : GRESIK UNITED vs PERSIRAM (Stadion Petrokimia Gresik)<br />
- 09/01/2013 : AREMA INDONESIA vs PERSIDAFON (Stadion Kanjuruhan)<br />
- 10/01/2013 : PELITA JAYA vs PERSIBA BALIKPAPAN (Stadion Siliwangi)<br />
- 11/01/2013 : SRIWIJAYA FC vs PS BARITO (Stadion Gelora Sriwijaya, Jakabaring)<br />
- 12/01/2013 : PERSIJA vs MITRA KUKAR (Stadion Utama Gelora Bung Karno)<br />
- 12/01/2013 : PSPS vs PERSISAM (Stadion Kuantan Singingi Sport Center)<br />
- 13/01/2013 : AREMA INDONESIA vs PERSIRAM (Stadion Kanjuruhan)<br />
- 13/01/2013 : PERSIB vs PERSIPURA (Stadion Siliwangi)<br />
- 13/01/2013 : PERSITA vs PERSIWA (Stadion Mashud Wisnusaputra)<br />
- 15/01/2013 : GRESIK UNITED vs PERSIDAFON (Stadion Petrokimia Gresik)<br />
- 16/01/2013 : PERSELA vs PERSEPAM MU (Stadion Surajaya)<br />
- 17/01/2013 : PERSIB vs PERSIWA (Stadion Siliwangi)<br />
- 19/01/2013 : PERSITA vs PERSIPURA (Stadion Mashud Wisnusaputra)<br />
- 19/01/2013 : MITRA KUKAR vs PELITA JAYA (Stadion AJI IMBUT)<br />
- 20/01/2013 : PERSISAM vs SRIWIJAYA FC (Stadion Segiri Samarinda)<br />
- 20/01/2013 : PS BARITO vs AREMA INDONESIA (Stadion Indrasari Martapura)<br />
- 22/01/2013 : PERSIBA BALIKPAPAN vs GRESIK UNITED (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 25/01/2013 : PERSISAM vs PELITA JAYA (Stadion Segiri Samarinda)<br />
- 26/01/2013 : MITRA KUKAR vs SRIWIJAYA FC (Stadion AJI IMBUT)<br />
- 26/01/2013 : PERSIBA BALIKPAPAN vs AREMA INDONESIA (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 27/01/2013 : PS BARITO vs GRESIK UNITED (Stadion Indrasari Martapura)<br />
- 27/01/2013 : PERSIJA vs PSPS (Stadion Utama Gelora Bung Karno)<br />
- 31/01/2013 : PERSIPURA vs PERSEPAM MU (Stadion Mandala)<br />
- 31/01/2013 : PERSIWA vs PERSELA (Stadion Pendidikan)<br />
- 31/01/2013 : PERSIRAM vs PERSIB (Stadion Wombik)<br />
- 31/01/2013 : PERSIDAFON vs PERSITA (Stadion BARNABAS YOUWE)<br />
<br />
<b>Bulan : Pebruari 2013</b><br />
- 02/02/2013 : SRIWIJAYA FC vs PERSIJA (Stadion Gelora Sriwijaya, Jakabaring)<br />
- 02/02/2013 : PELITA JAYA vs PSPS (Stadion Siliwangi)<br />
- 03/02/2013 : GRESIK UNITED vs PERSISAM (Stadion Petrokimia Gresik)<br />
- 03/02/2013 : AREMA INDONESIA vs MITRA KUKAR (Stadion Kanjuruhan)<br />
- 03/02/2013 : PERSIPURA vs PERSELA (Stadion Mandala)<br />
- 03/02/2013 : PERSIWA vs PERSEPAM MU (Stadion Pendidikan)<br />
- 04/02/2013 : PERSIRAM vs PERSITA (Stadion Wombik)<br />
- 04/02/2013 : PERSIDAFON vs PERSIB (Stadion BARNABAS YOUWE)<br />
- 05/02/2013 : PELITA JAYA vs PERSIJA (Stadion Siliwangi)<br />
- 06/02/2013 : SRIWIJAYA FC vs PSPS (Stadion Gelora Sriwijaya, Jakabaring)<br />
- 07/02/2013 : AREMA INDONESIA vs PERSISAM (Stadion Kanjuruhan)<br />
- 08/02/2013 : GRESIK UNITED vs MITRA KUKAR (Stadion Petrokimia Gresik)<br />
- 09/02/2013 : PERSIB vs PERSIBA BALIKPAPAN (Stadion Siliwangi)<br />
- 09/02/2013 : PERSEPAM MU vs PERSIDAFON (Stadion Gelora Bangkalan)<br />
- 10/02/2013 : PERSIPURA vs PERSIWA (Stadion Mandala)<br />
- 10/02/2013 : PERSITA vs PS BARITO (Stadion Mashud Wisnusaputra)<br />
- 10/02/2013 : PERSELA vs PERSIRAM (Stadion Surajaya)<br />
- 12/02/2013 : PSPS vs AREMA INDONESIA (Stadion Kuantan Singingi Sport Center)<br />
- 12/02/2013 : PERSIJA vs GRESIK UNITED (Stadion Utama Gelora Bung Karno)<br />
- 13/02/2013 : PERSIB vs PS BARITO (Stadion Siliwangi)<br />
- 13/02/2013 : PERSITA vs PERSIBA BALIKPAPAN (Stadion Mashud Wisnusaputra)<br />
- 14/02/2013 : PERSEPAM MU vs PERSIRAM (Stadion Gelora Bangkalan)<br />
- 14/02/2013 : PERSELA vs PERSIDAFON (Stadion Surajaya)<br />
- 16/02/2013 : PSPS vs GRESIK UNITED (Stadion Kuantan Singingi Sport Center)<br />
- 16/02/2013 : PERSIJA vs AREMA INDONESIA (Stadion Utama Gelora Bung Karno)<br />
- 17/02/2013 : SRIWIJAYA FC vs PELITA JAYA (Stadion Gelora Sriwijaya,
Jakabaring)<br />
- 17/02/2013 : PERSISAM vs PERSIB (Stadion Segiri Samarinda)<br />
- 17/02/2013 : MITRA KUKAR vs PERSITA (Stadion AJI IMBUT)<br />
- 18/02/2013 : PERSIRAM vs PERSIPURA (Stadion Wombik)<br />
- 18/02/2013 : PERSIDAFON vs PERSIWA (Stadion BARNABAS YOUWE)<br />
- 19/02/2013 : PS BARITO vs PERSEPAM MU (Stadion Indrasari Martapura)<br />
- 19/02/2013 : PERSIBA BALIKPAPAN vs PERSELA (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 20/02/2013 : PERSISAM vs PERSITA (Stadion Segiri Samarinda)<br />
- 21/02/2013 : MITRA KUKAR vs PERSIB (Stadion AJI IMBUT)<br />
- 22/02/2013 : PERSIRAM vs PERSIWA (Stadion Wombik)<br />
- 22/02/2013 : PERSIDAFON vs PERSIPURA (Stadion BARNABAS YOUWE)<br />
- 23/02/2013 : PS BARITO vs PERSELA (Stadion Indrasari Martapura)<br />
- 23/02/2013 : PERSIBA BALIKPAPAN vs PERSEPAM MU (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 24/02/2013 : AREMA INDONESIA vs SRIWIJAYA FC (Stadion Kanjuruhan)<br />
- 24/02/2013 : GRESIK UNITED vs PELITA JAYA (Stadion Petrokimia Gresik)<br />
- 26/02/2013 : PERSITA vs PERSIJA (Stadion Mashud Wisnusaputra)<br />
- 27/02/2013 : PERSIB vs PSPS (Stadion Siliwangi)<br />
- 27/02/2013 : PERSIPURA vs PERSIBA BALIKPAPAN (Stadion Mandala)<br />
- 27/02/2013 : PERSIWA vs PS BARITO (Stadion Pendidikan)<br />
- 28/02/2013 : AREMA INDONESIA vs PELITA JAYA (Stadion Kanjuruhan)</span><br />
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<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bulan :
Maret 2013</span></b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
- 01/03/2013 : GRESIK UNITED vs SRIWIJAYA FC (Stadion Petrokimia Gresik)<br />
- 02/03/2013 : PERSELA vs PERSISAM (Stadion Surajaya)<br />
- 02/03/2013 : PERSITA vs PSPS (Stadion Mashud Wisnusaputra)<br />
- 03/03/2013 : PERSIB vs PERSIJA (Stadion Siliwangi)<br />
- 03/03/2013 : PERSEPAM MU vs MITRA KUKAR (Stadion Gelora Bangkalan)<br />
- 03/03/2013 : PERSIPURA vs PS BARITO (Stadion Mandala)<br />
- 03/03/2013 : PERSIWA vs PERSIBA BALIKPAPAN (Stadion Pendidikan)<br />
- 03/03/2013 : PERSIRAM vs PERSIDAFON (Stadion Wombik)<br />
- 06/03/2013 : PERSEPAM MU vs PERSISAM (Stadion Gelora Bangkalan)<br />
- 06/03/2013 : PERSELA vs MITRA KUKAR (Stadion Surajaya)<br />
- 07/03/2013 : GRESIK UNITED vs AREMA INDONESIA (Stadion Petrokimia Gresik)<br />
- 09/03/2013 : SRIWIJAYA FC vs PERSIB (Stadion Gelora Sriwijaya, Jakabaring)<br />
- 09/03/2013 : PELITA JAYA vs PERSITA (Stadion Siliwangi)<br />
- 09/03/2013 : PS BARITO vs PERSIDAFON (Stadion Indrasari Martapura)<br />
- 09/03/2013 : PERSIBA vs BALIKPAPAN PERSIRAM (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 10/03/2013 : PERSISAM vs PERSIPURA (Stadion Segiri Samarinda)<br />
- 10/03/2013 : MITRA KUKAR vs PERSIWA (Stadion AJI IMBUT)<br />
- 10/03/2013 : PERSIJA vs PERSELA (Stadion Utama Gelora Bung Karno)<br />
- 10/03/2013 : PSPS vs PERSEPAM MU (Stadion Kuantan Singingi Sport Center)<br />
- 13/03/2013 : SRIWIJAYA FC vs PERSITA (Stadion Gelora Sriwijaya, Jakabaring)<br />
- 13/03/2013 : PELITA JAYA vs PERSIB (Stadion Siliwangi)<br />
- 13/03/2013 : PS BARITO vs PERSIRAM (Stadion Indrasari Martapura)<br />
- 13/03/2013 : PERSIBA BALIKPAPAN vs PERSIDAFON (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 14/03/2013 : PERSISAM vs PERSIWA (Stadion Segiri Samarinda)<br />
- 14/03/2013 : MITRA KUKAR vs PERSIPURA (Stadion AJI IMBUT)<br />
- 14/03/2013 : PERSIJA vs PERSEPAM MU (Stadion Utama Gelora Bung Karno)<br />
- 16/03/2013 : PSPS vs PERSELA Kuantan (Stadion Singingi Sport Center)<br />
- 16/03/2013 : PERSIB vs AREMA INDONESIA (Stadion Siliwangi)<br />
- 17/03/2013 : PERSITA vs GRESIK UNITED (Stadion Mashud Wisnusaputra)<br />
- 19/03/2013 : PERSIRAM vs MITRA KUKAR (Stadion Wombik)<br />
- 19/03/2013 : PERSIDAFON vs PERSISAM (Stadion BARNABAS YOUWE)<br />
- 19/03/2013 : PERSEPAM MU vs SRIWIJAYA FC (Stadion Gelora Bangkalan)<br />
- 20/03/2013 : PERSELA vs PELITA JAYA (Stadion Surajaya)<br />
- 21/03/2013 : PERSIPURA vs PSPS (Stadion Mandala)<br />
- 21/03/2013 : PERSIWA vs PERSIJA (Stadion Pendidikan)<br />
- 21/03/2013 : PERSIBA BALIKPAPAN vs PS BARITO (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 23/03/2013 : PERSIRAM vs PERSISAM (Stadion Wombik)<br />
- 23/03/2013 : PERSIDAFON vs MITRA KUKAR (Stadion BARNABAS YOUWE)<br />
- 23/03/2013 : PERSIB vs GRESIK UNITED (Stadion Siliwangi)<br />
- 23/03/2013 : PERSEPAM MU vs PELITA JAYA (Stadion Gelora Bangkalan)<br />
- 24/03/2013 : PERSITA vs AREMA INDONESIA (Stadion Mashud Wisnusaputra)<br />
- 24/03/2013 : PERSELA vs SRIWIJAYA FC (Stadion Surajaya)<br />
- 24/03/2013 : PERSIPURA vs PERSIJA (Stadion Mandala)<br />
- 24/03/2013 : PERSIWA vs PSPS (Stadion Pendidikan)<br />
- 28/03/2013 : PERSIB vs PERSITA (Stadion Siliwangi)<br />
- 30/03/2013 : PERSISAM vs PERSIBA BALIKPAPAN (Stadion Segiri Samarinda)<br />
- 30/03/2013 : PERSIJA vs PERSIRAM (Stadion Utama Gelora Bung Karno)<br />
- 31/03/2013 : MITRA KUKAR vs PS BARITO AJI IMBUT)<br />
- 31/03/2013 : PSPS vs PERSIDAFON (Stadion Kuantan Singingi Sport Center)</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bulan: April
2013</span></b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
- 02/04/2013 : GRESIK UNITED vs PERSELA (Stadion Petrokimia Gresik)<br />
- 03/04/2013 : AREMA INDONESIA vs PERSEPAM MU (Stadion Kanjuruhan)<br />
- 04/04/2013 : MITRA KUKAR vs PERSIBA BALIKPAPAN (Stadion AJI IMBUT)<br />
- 06/04/2013 : PERSIJA vs PERSIDAFON (Stadion Utama Gelora Bung Karno)<br />
- 06/04/2013 : PSPS vs PERSIRAM (Stadion Kuantan Singingi Sport Center)<br />
- 06/04/2013 : AREMA INDONESIA vs PERSELA (Stadion Kanjuruhan)<br />
- 07/04/2013 : PERSISAM vs PS BARITO (Stadion Segiri Samarinda)<br />
- 07/04/2013 : PELITA JAYA vs PERSIPURA (Stadion Siliwangi)<br />
- 09/04/2013 : SRIWIJAYA FC vs PERSIWA (Stadion Gelora Sriwijaya, Jakabaring)<br />
- 10/04/2013 : GRESIK UNITED vs PERSEPAM MU (Stadion Petrokimia Gresik)<br />
- 13/04/2013 : SRIWIJAYA FC vs PERSIPURA (Stadion Gelora Sriwijaya, Jakabaring)<br />
- 13/04/2013 : PELITA JAYA vs PERSIWA (Stadion Siliwangi)<br />
- 14/04/2013 : PERSELA vs PERSIB (Stadion Surajaya)<br />
- 14/04/2013 : PERSEPAM MU vs PERSITA (Stadion Gelora Bangkalan)<br />
- 16/04/2013 : PERSIBA BALIKPAPAN vs PSPS (Stadion Persiba, Komplek Pertamina
Parikesit)<br />
- 17/04/2013 : PS BARITO vs PERSIJA (Stadion Indrasari Martapura)<br />
- 17/04/2013 : PERSIRAM vs PELITA JAYA (Stadion Wombik)<br />
- 17/04/2013 : PERSIDAFON vs SRIWIJAYA FC (Stadion BARNABAS YOUWE)<br />
- 17/04/2013 : PERSIPURA vs GRESIK UNITED (Stadion Mandala)<br />
- 17/04/2013 : PERSIWA vs AREMA INDONESIA (Stadion Pendidikan)<br />
- 18/04/2013 : PERSISAM vs MITRA KUKAR (Stadion Segiri Samarinda)<br />
- 20/04/2013 : PERSELA vs PERSITA (Stadion Surajaya)<br />
- 20/04/2013 : PS BARITO vs PSPS (Stadion Indrasari Martapura)<br />
- 21/04/2013 : PERSEPAM MU vs PERSIB (Stadion Gelora Bangkalan)<br />
- 21/04/2013 : PERSIBA BALIKPAPAN vs PERSIJA (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 21/04/2013 : PERSIRAM vs SRIWIJAYA FC (Stadion Wombik)<br />
- 21/04/2013 : PERSIDAFON vs PELITA JAYA (Stadion BARNABAS YOUWE)<br />
- 21/04/2013 : PERSIPURA vs AREMA INDONESIA (Stadion Mandala)<br />
- 21/04/2013 : PERSIWA vs GRESIK UNITED (Stadion Pendidikan)</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bulan: Mei
2013</span></b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
- 04/05/2013 : PERSIJA vs PERSIBA BALIKPAPAN (Stadion Utama Gelora Bung Karno)<br />
- 04/05/2013 : PSPS vs PS BARITO (Stadion Kuantan Singingi Sport Center)<br />
- 04/05/2013 : PELITA JAYA vs PERSIDAFON (Stadion Siliwangi)<br />
- 05/05/2013 : SRIWIJAYA FC vs PERSIRAM (Stadion Gelora Sriwijaya, Jakabaring)<br />
- 05/05/2013 : MITRA KUKAR vs PERSISAM (Stadion AJI IMBUT)<br />
- 05/05/2013 : PERSIB vs PERSELA (Stadion Siliwangi)<br />
- 05/05/2013 : AREMA INDONESIA vs PERSIPURA (Stadion Kanjuruhan)<br />
- 07/05/2013 : PERSITA vs PERSEPAM MU (Stadion Mashud Wisnusaputra)<br />
- 07/05/2013 : GRESIK UNITED vs PERSIWA (Stadion Petrokimia Gresik)<br />
- 08/05/2013 : PERSIJA vs PS BARITO (Stadion Utama Gelora Bung Karno)<br />
- 08/05/2013 : PSPS vs PERSIBA BALIKPAPAN (Stadion Kuantan Singingi Sport
Center)<br />
- 10/05/2013 : SRIWIJAYA FC vs PERSIDAFON (Stadion Gelora Sriwijaya,
Jakabaring)<br />
- 10/05/2013 : PELITA JAYA vs PERSIRAM (Stadion Siliwangi)<br />
- 11/05/2013 : PERSITA vs PERSELA (Stadion Mashud Wisnusaputra)<br />
- 11/05/2013 : AREMA INDONESIA vs PERSIWA (Stadion Kanjuruhan)<br />
- 12/05/2013 : PERSIB vs PERSEPAM MU (Stadion Siliwangi)<br />
- 12/05/2013 : GRESIK UNITED vs PERSIPURA (Stadion Petrokimia Gresik)<br />
- 14/05/2013 : PS BARITO vs MITRA KUKAR (Stadion Indrasari Martapura)<br />
- 14/05/2013 : PERSIBA BALIKPAPAN vs PERSISAM (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 15/05/2013 : PERSIRAM vs PERSIJA (Stadion Wombik)<br />
- 15/05/2013 : PERSIDAFON vs PSPS (Stadion BARNABAS YOUWE)<br />
- 15/05/2013 : PERSELA vs AREMA INDONESIA (Stadion Surajaya)<br />
- 16/05/2013 : PERSEPAM MU vs GRESIK UNITED (Stadion Gelora Bangkalan)<br />
- 17/05/2013 : PERSIPURA vs PELITA JAYA (Stadion Mandala)<br />
- 17/05/2013 : PERSIWA vs SRIWIJAYA FC (Stadion Pendidikan)<br />
- 18/05/2013 : PS BARITO vs PERSISAM (Stadion Indrasari Martapura)<br />
- 18/05/2013 : PERSIBA BALIKPAPAN vs MITRA KUKAR (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 18/05/2013 : PERSITA vs PERSIB (Stadion Mashud Wisnusaputra)<br />
- 19/05/2013 : PERSIRAM vs PSPS (Stadion Wombik)<br />
- 19/05/2013 : PERSIDAFON vs PERSIJA (Stadion BARNABAS YOUWE)<br />
- 19/05/2013 : PERSEPAM MU vs AREMA INDONESIA (Stadion Gelora Bangkalan)<br />
- 19/05/2013 : PERSELA vs GRESIK UNITED (Stadion Surajaya)<br />
- 21/05/2013 : PERSIPURA vs SRIWIJAYA FC (Stadion Mandala)<br />
- 21/05/2013 : PERSIWA vs PELITA JAYA (Stadion Pendidikan)<br />
- 23/05/2013 : GRESIK UNITED vs PERSITA (Stadion Petrokimia Gresik)<br />
- 25/05/2013 : AREMA INDONESIA vs PERSIB (Stadion Kanjuruhan)<br />
- 25/05/2013 : MITRA KUKAR vs PERSIDAFON (Stadion AJI IMBUT)<br />
- 25/05/2013 : PERSISAM vs PERSIRAM (Stadion Segiri Samarinda)<br />
- 25/05/2013 : PERSIJA vs PERSIWA (Stadion Utama Gelora Bung Karno)<br />
- 26/05/2013 : SRIWIJAYA FC vs PERSELA (Stadion Gelora Sriwijaya, Jakabaring)<br />
- 26/05/2013 : PELITA JAYA vs PERSEPAM MU (Stadion Siliwangi)<br />
- 26/05/2013 : PSPS vs PERSIPURA (Stadion Kuantan Singingi Sport Center)<br />
- 26/05/2013 : PS BARITO vs PERSIBA BALIKPAPAN (Stadion Indrasari Martapura)<br />
- 28/05/2013 : MITRA KUKAR vs PERSIRAM (Stadion AJI IMBUT)<br />
- 28/05/2013 : AREMA INDONESIA vs PERSITA (Stadion Kanjuruhan)<br />
- 29/05/2013 : GRESIK UNITED vs PERSIB (Stadion Petrokimia Gresik)<br />
- 29/05/2013 : SRIWIJAYA FC vs PERSEPAM MU (Stadion Gelora Sriwijaya,
Jakabaring)<br />
- 30/05/2013 : PERSISAM vs PERSIDAFON (Stadion Segiri Samarinda)<br />
- 31/05/2013 : PSPS vs PERSIWA (Stadion Kuantan Singingi Sport Center)</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bulan : Juni
2013</span></b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
- 01/06/2013 : PERSIJA vs PERSIPURA (Stadion Utama Gelora Bung Karno)<br />
- 01/06/2013 : PELITA JAYA vs PERSELA (Stadion Siliwangi)<br />
- 02/06/2013 : AREMA INDONESIA vs GRESIK UNITED (Stadion Kanjuruhan)<br />
- 02/06/2013 : PERSITA vs SRIWIJAYA FC (Stadion Mashud Wisnusaputra)<br />
- 04/06/2013 : PERSIB vs PELITA JAYA (Stadion Siliwangi)<br />
- 04/06/2013 : PERSIRAM vs PERSIBA BALIKPAPAN (Stadion Wombik)<br />
- 04/06/2013 : PERSIDAFON vs PS BARITO (Stadion BARNABAS YOUWE)<br />
- 05/06/2013 : PERSELA vs PSPS (Stadion Surajaya)<br />
- 05/06/2013 : PERSIPURA vs PERSISAM (Stadion Mandala)<br />
- 05/06/2013 : PERSIWA vs MITRA KUKAR (Stadion Pendidikan)<br />
- 05/06/2013 : PERSEPAM MU vs PERSIJA (Stadion Gelora Bangkalan)<br />
- 08/06/2013 : PERSIB vs SRIWIJAYA FC (Stadion Siliwangi)<br />
- 08/06/2013 : PERSITA vs PELITA JAYA (Stadion Mashud Wisnusaputra)<br />
- 08/06/2013 : PERSIRAM vs PS BARITO (Stadion Wombik)<br />
- 08/06/2013 : PERSIDAFON vs PERSIBA BALIKPAPAN (Stadion BARNABAS YOUWE)<br />
- 09/06/2013 : PERSELA vs PERSIJA (Stadion Surajaya)<br />
- 09/06/2013 : PERSEPAM MU vs PSPS (Stadion Gelora Bangkalan)<br />
- 09/06/2013 : PERSIPURA vs MITRA (Stadion KUKAR Mandala)<br />
- 09/06/2013 : PERSIWA vs PERSISAM (Stadion Pendidikan)<br />
- 11/06/2013 : PELITA JAYA vs AREMA INDONESIA (Stadion Siliwangi)<br />
- 12/06/2013 : SRIWIJAYA FC vs GRESIK UNITED (Stadion Gelora Sriwijaya,
Jakabaring)<br />
- 13/06/2013 : PERSIBA BALIKPAPAN vs PERSIPURA (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 14/06/2013 : PS BARITO vs PERSIWA (Stadion Indrasari Martapura)<br />
- 15/06/2013 : PERSIJA vs PERSIB (Stadion Utama Gelora Bung Karno)<br />
- 15/06/2013 : PSPS vs PERSITA (Stadion Kuantan Singingi Sport Center)<br />
- 15/06/2013 : MITRA KUKAR vs PERSEPAM MU (Stadion AJI IMBUT)<br />
- 16/06/2013 : SRIWIJAYA FC vs AREMA INDONESIA (Stadion Gelora Sriwijaya,
Jakabaring)<br />
- 16/06/2013 : PELITA JAYA vs GRESIK UNITED (Stadion Siliwangi)<br />
- 16/06/2013 : PERSISAM vs PERSELA (Stadion Segiri Samarinda)<br />
- 16/06/2013 : PERSIDAFON vs PERSIRAM (Stadion BARNABAS YOUWE)<br />
- 18/06/2013 : PS BARITO vs PERSIPURA (Stadion Indrasari Martapura)<br />
- 18/06/2013 : PSPS vs PERSIB (Stadion Kuantan Singingi Sport Center)<br />
- 19/06/2013 : PERSIBA BALIKPAPAN vs PERSIWA (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 19/06/2013 : PERSIJA vs PERSITA (Stadion Utama Gelora Bung Karno)<br />
- 19/06/2013 : PERSISAM vs PERSEPAM MU (Stadion Segiri Samarinda)<br />
- 20/06/2013 : MITRA KUKAR vs PERSELA (Stadion AJI IMBUT)<br />
- 22/06/2013 : PELITA JAYA vs SRIWIJAYA FC (Stadion Siliwangi)<br />
- 22/06/2013 : GRESIK UNITED vs PSPS (Stadion Petrokimia Gresik)<br />
- 23/06/2013 : AREMA INDONESIA vs PERSIJA (Stadion Kanjuruhan)<br />
- 23/06/2013 : PERSIB vs PERSISAM (Stadion Siliwangi)<br />
- 25/06/2013 : PERSITA vs MITRA KUKAR (Stadion Mashud Wisnusaputra)<br />
- 26/06/2013 : PERSIPURA vs PERSIDAFON (Stadion Mandala)<br />
- 26/06/2013 : PERSIWA vs PERSIRAM (Stadion Pendidikan)<br />
- 26/06/2013 : PERSELA vs PERSIBA BALIKPAPAN (Stadion Surajaya)<br />
- 26/06/2013 : PERSEPAM MU vs PS BARITO (Stadion Gelora Bangkalan)<br />
- 27/06/2013 : GRESIK UNITED vs PERSIJA (Stadion Petrokimia Gresik)<br />
- 27/06/2013 : AREMA INDONESIA vs PSPS (Stadion Kanjuruhan)<br />
- 29/06/2013 : PERSIB vs MITRA KUKAR (Stadion Siliwangi)<br />
- 29/06/2013 : PERSELA vs PS BARITO (Stadion Surajaya)<br />
- 30/06/2013 : PERSIPURA vs PERSIRAM (Stadion Mandala)<br />
- 30/06/2013 : PERSIWA vs PERSIDAFON (Stadion Pendidikan)<br />
- 30/06/2013 : PERSITA vs PERSISAM (Stadion Mashud Wisnusaputra)<br />
- 30/06/2013 : PERSEPAM MU vs PERSIBA BALIKPAPAN (Stadion Gelora Bangkalan)</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bulan : Juli
2013</span></b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
- 19/07/2013 : MITRA KUKAR vs AREMA INDONESIA (Stadion AJI IMBUT)<br />
- 20/07/2013 : PS BARITO vs PERSITA (Stadion Indrasari Martapura)<br />
- 21/07/2013 : PERSIJA vs PELITA JAYA (Stadion Utama Gelora Bung Karno)<br />
- 21/07/2013 : PERSIRAM vs PERSELA (Stadion Wombik)<br />
- 21/07/2013 : PERSIDAFON vs PERSEPAM MU (Stadion BARNABAS YOUWE)<br />
- 22/07/2013 : PSPS vs SRIWIJAYA FC (Stadion Kuantan Singingi Sport Center)<br />
- 23/07/2013 : PERSISAM vs AREMA INDONESIA (Stadion Segiri Samarinda)<br />
- 24/07/2013 : PERSIBA BALIKPAPAN vs PERSITA (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 25/07/2013 : MITRA KUKAR vs GRESIK UNITED (Stadion AJI IMBUT)<br />
- 25/07/2013 : PERSIRAM vs PERSEPAM MU (Stadion Wombik)<br />
- 25/07/2013 : PERSIDAFON vs PERSELA (Stadion BARNABAS YOUWE)<br />
- 26/07/2013 : PS BARITO vs PERSIB (Stadion Indrasari Martapura)<br />
- 27/07/2013 : PSPS vs PELITA JAYA (Stadion Kuantan Singingi Sport Center)<br />
- 28/07/2013 : PERSIJA vs SRIWIJAYA FC (Stadion Utama Gelora Bung Karno)<br />
- 28/07/2013 : PERSIWA vs PERSIPURA (Stadion Pendidikan)<br />
- 29/07/2013 : PERSISAM vs GRESIK UNITED (Stadion Segiri Samarinda)<br />
- 30/07/2013 : PERSIBA vs BALIKPAPAN PERSIB (Stadion Persiba, Komplek Pertamina
Parikesit)</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bulan :
Agustus 2013</span></b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
- 20/08/2013 : PERSIB vs PERSIDAFON (Stadion Siliwangi)<br />
- 20/08/2013 : PERSITA vs PERSIRAM (Stadion Mashud Wisnusaputra)<br />
- 21/08/2013 : GRESIK UNITED vs PERSIBA BALIKPAPAN (Stadion Petrokimia Gresik)<br />
- 21/08/2013 : AREMA INDONESIA vs PS BARITO (Stadion Kanjuruhan)<br />
- 22/08/2013 : PERSELA vs PERSIPURA (Stadion Surajaya)<br />
- 23/08/2013 : PERSEPAM MU vs PERSIWA (Stadion Gelora Bangkalan)<br />
- 24/08/2013 : PERSIB vs PERSIRAM (Stadion Siliwangi)<br />
- 24/08/2013 : SRIWIJAYA vs FC MITRA KUKAR (Stadion Gelora Sriwijaya,
Jakabaring)<br />
- 24/08/2013 : GRESIK UNITED vs PS BARITO (Stadion Petrokimia Gresik)<br />
- 25/08/2013 : PERSITA vs PERSIDAFON (Stadion Mashud Wisnusaputra)<br />
- 25/08/2013 : PELITA JAYA vs PERSISAM (Stadion Siliwangi)<br />
- 25/08/2013 : AREMA INDONESIA vs PERSIBA BALIKPAPAN (Stadion Kanjuruhan)<br />
- 26/08/2013 : PSPS vs PERSIJA (Stadion Kuantan Singingi Sport Center)<br />
- 27/08/2013 : PERSELA vs PERSIWA (Stadion Surajaya)<br />
- 27/08/2013 : PERSEPAM MU vs PERSIPURA (Stadion Gelora Bangkalan)<br />
- 28/08/2013 : PELITA JAYA vs MITRA KUKAR (Stadion Siliwangi)<br />
- 29/08/2013 : SRIWIJAYA FC vs PERSISAM (Stadion Gelora Sriwijaya, Jakabaring)</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bulan:
September 2013</span></b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><br />
- 03/09/2013 : PS BARITO vs PELITA JAYA (Stadion Indrasari Martapura)<br />
- 03/09/2013 : PERSIBA BALIKPAPAN vs SRIWIJAYA FC (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 03/09/2013 : MITRA KUKAR vs PSPS (Stadion AJI IMBUT)<br />
- 03/09/2013 : PERSISAM vs PERSIJA (Stadion Segiri Samarinda)<br />
- 03/09/2013 : PERSIPURA vs PERSIB (Stadion Mandala)<br />
- 03/09/2013 : PERSIWA vs PERSITA (Stadion Pendidikan)<br />
- 03/09/2013 : PERSIRAM vs GRESIK UNITED (Stadion Wombik)<br />
- 03/09/2013 : PERSIDAFONvs AREMA INDONESIA (Stadion BARNABAS YOUWE)<br />
- 07/09/2013 : PERSEPAM MU vs PERSELA (Stadion Gelora Bangkalan)<br />
- 07/09/2013 : PS BARITO vs SRIWIJAYA FC (Stadion Indrasari Martapura)<br />
- 07/09/2013 : PERSIBA BALIKPAPAN vs PELITA JAYA (Stadion Persiba, Komplek
Pertamina Parikesit)<br />
- 07/09/2013 : MITRA KUKAR vs PERSIJA (Stadion AJI IMBUT)<br />
- 07/09/2013 : PERSISAM vs PSPS (Stadion Segiri Samarinda)<br />
- 07/09/2013 : PERSIPURA vs PERSITA (Stadion Mandala)<br />
- 07/09/2013 : PERSIWA vs PERSIB (Stadion Pendidikan)<br />
- 07/09/2013 : PERSIRAM vs AREMA INDONESIA (Stadion Stadion Wombik)<br />
- 07/09/2013 : PERSIDAFON vs GRESIK UNITED (Stadion BARNABAS YOUWE)</span></div>
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Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-61336848194016362782013-01-22T09:26:00.000-08:002013-01-22T09:32:27.085-08:00STANDARISASI SIMPLISIA DAN EKSTRAK<div dir="ltr" style="text-align: left;" trbidi="on">
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</xml><![endif]--><span style="font-family: "Times New Roman","serif";">PENGERTIAN</span><br />
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">STANDARISASI adalah proses dalam penetapan atau merumuskan dan merevisi standar yang dilaksanakan secara tertib.standar adalah sesuatu yang dilakukan dan disusun berdasarkan konsesus semua
pihak terkait dengan memperhatikan syarat-syarat kesehatan, keamanan,
keselamatan lingkungan, berdasarkan pengalaman, perkembangan masa kini dan masa
yang akan datang untuk memperoleh manfaat yang sebesar-besarnya<br />
STANDARISASI DALAM PENETAPAN TEKNOLOGI<br />
</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">Ø</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"> Pre-Farm<br />
</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">Ø</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"> On-Farm<br />
</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">Ø</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"> Off-Farm<br />
</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">Ø</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"> Teknologi panca panen<br />
</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">Ø</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"> Teknologi ekstrak standar<br />
</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">Ø</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"> Teknologi pengujian khasiat dan toksisitas<br />
</span><span style="font-family: Symbol; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">Ø</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"> Teknologi produksi obet herbal<br />
3. Standarisasi simplisia<br />
Syarat yang harus dipenuhi antara lain kemurnian simplisia, tidak mengandung
pestisida berbahaya, logam berat, dan senyawa toksik dan beberapa persyaratan
lain dalam Farmakope Indonesia.<br />
4. Standarisasi ekstrak<br />
Kegunaan ekstrak obat terstandar antara lain memepertahankan konsistensi
kandungan senyawa aktif batch yang diproduksi, pemekatan kandungan senyawa
aktif pada ekstrak<br />
<br />
Parameter yang ditetapkan dalam standarisasi ekstrak antara lain: parameter non
spesifik dan parameter spesifik.<br />
Parameter non spesifik yaitu susut pengeringan dan bobot jenis, kadar air,
kadar abu, sisa pelarut, residu pestisida<br />
Parameter spesifik yaitu identitas, organoleptik, senyawa terlarut pada pelarut
polar dan non polar serta profil kromatografi.<br />
<br />
5. Herbal terstandar dan fitofarmaka<br />
Yang harus diperhatikan dalam pemeriksaan mutu simplisisa adalah<br />
a. Simplisis harus memenuhi persyaratan umum edisi terakhir dari buku-buku
acuan yang dikeluarkan oleh Departemen Kesehatan RI<br />
b. Terdapat simplisia pembanding yang setiap periode harus diperbaharui.<br />
c. Dilakukan pemeriksaan mutu fisi secara tepat.<br />
d. Dilakukan pemeriksaan secara lengkap seperti pemeriksaan organolepti,
makrokospis, mikrokospis, pemeriksaan fisika, kimiawi, kromatografi.<br />
6. Parameter standarisasi<br />
Parameter standarisasi antara lain:<br />
• Organoleptik<br />
Pemeriksaan meliputi warna, bau, dan rasa. <br />
• Makrokospis<br />
Pemeriksaan dengan dilihat secara langsung, dapat juga dengan bantuan kaca
pembesar<br />
• Mikrokosis<br />
Pemeriksaan dengan melihat jaringan sel simplisia dibawah mikroskop<br />
• Fluoresensi<br />
Uji ini dapat dilakukan terhadap ekstrak, atau larutan yang dibuat dari
simplisia<br />
• Kelarutan<br />
Dilakukan pada simplisia yang berupa eksudat tanaman<br />
• Reaksi warna , pengendapan, dan reaksi lain<br />
Pada reaksi warna dapat dilakukan pada simplisia yang telah diserbuk<br />
Pada reaksi pengendapan dilakukan pada ekstrak larutan simplisia yang jernih.<br />
• Kromatografi<br />
Cara ini mempunyai kepekaan yang tinggi, cepat, sederhana dan murah.<br />
• Penetapan kadar<br />
Syarat untuk dapat diterapkannya pengujian yang berupa zat ini adalah telah
diketahui secara pasti kadar minimal zat berkhasiat yang harus dikandung oleh
simplisia<br />
• Cemaran mikroba dan aflatoksin<br />
Seperti Aspergillus flavus, merupakan mikroba jamur yang tidak berbahaya,
tetapi metabolit aflatoksinnya menyebabkan keracunan.<br />
• Cemaran logam berat<br />
Seperti cemaran hydrogen sulfida tidak boleh melebihi batas logam berat pada
monografi yang dinyatakan sebagai timbal</span></div>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-11610508368568068122013-01-22T09:23:00.007-08:002016-02-06T09:41:08.786-08:00NUTRISI PARENTERAL<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><b>LATAR BELAKANG</b></span><br />
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Penderita dengan trauma yang besar, sakit berat atau sepsis mengalami
peningkatan kebutuhan energi, peningkatan katabolisme disertai kehilangan massa
tubuh yang cepat. Meskipun pemberian nutrisi konvensional mampu dengan baik
mengatasi malnutrisi biasa, bahkan hiperalimentasi ternyata gagal mengatasi
perubahan metabolik terhadap pasien-pasien seperti diatas. Penurunan berat
badan, kehilangan otot yang mengakibatkan keseimbangan nitrogen yang negatif
tetap saja terjadi, berapapun jumlah nutrisi yang diberikan. Hal ini karena
respons metabolik pada pasien sakit kritis, trauma hebat dan atau disertai
tindakan operasi dan sepsis sangat berbeda dengan dengan penderita <i>malnutrisi/starvasi</i>
(kekurangan gizi akibat intake yang kurang). Selama beberapa dekade terakhir
ini jumlah energi yang diberikan pada pasien sepsis atau sakit berat termasuk
penderita trauma dengan SIRS justru menurun, karena telah dibuktikan bahwa
kebutuhan energi pasien tidaklah jauh berbeda dengan pasien normal.
Hipermetabolisme yang timbul pada kenyataannya diimbangi dengan aktifitas fisik
yang menurun. Oleh karena itu strategi untuk mengatasi kehilangan otot dan
keseimbangan nitrogen yang negatif adalah mengatasi penyebab hipermetabolisme
dan memberi tunjangan nutrisi yang adekwat dalam kualitas bukan kwantitas.
Pemahaman penyebab terjadinya hipermetabolisme ini berarti adalah pemahaman
yang jelas dari <i>respons metabolik</i>. Respons ini terkait dengan berbagai
reaksi akibat adanya trauma, seperti neuroendokrin, imunologis dan mencakup
berbagai macam mediator inflamasi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi
seperti halnya oksigen dan cairan senantiasa dibutuhkan oleh tubuh. Penderita
yang tidak dapat makan atau tidak boleh makan harus tetap mendapat masukan
nutrisi melalui cara enteral (pipa nasogastrik) atau cara parentral
(intravena). Nutrisi parenteral tidak menggantikan fungsi alamiah usus, karena
itu hanya merupakan jalan pintas sementara sampai usus berfungsi normal
kembali. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tehnik
nutrisi parenteral memang tidak mudah dan penuh liku-liku masaalah biokimia dan
fisiologi. Juga harga relatif mahal tetapi jika digunakan dengan benar pada
penderita yang tepat, pada akhirnya akan dapat dihemat lebih banyak biaya yang
semestinya keluar untuk antibiotik dan waktu tinggal dirumah sakit .Contoh
kesalahan yang masih banyak ditemukan di rumah sakit yaitu Pemberian protein
tanpa kalori karbohidrat yang cukup dan Pemberian cairan melalui vena perifer
dimana osmolaritas cairan tersebut lebih dari 900 m Osmol yang seharusnya
melalui vena sentral.1,2 Jika krisis katabolisme kecil sedang tubuh mempunyai
cukup cadangan tidak timbul masalah apapun. Penderita dewasa mudah sehat dengan
status gisi yang baik, dapat menjalani pembedahan, puasa 5 –7 hari setelah
operasi sembuh dan pulang dengan selamat hanya dengan kerugian penurunana berat
badan. Tetapi pada kenyataannya lebih banyak penderita yang kondisi awalnya
sudah jelek ( berat badan kurang, kadar albumin < 3,5 gr/dl), untuk
penderita ini puasa pasca bedah / pasca trauma 5 – 7 hari hanya mendapat infus
elektrolit sudah cukup untuk mencetuskan hipoalbuminemia, hambatan penyenbuhan
luka , penurunan daya tahan tubuh sehingga infeksi mudah menyebar. Sehingga
banyak diantara penderita pasca bedah laparotomi karena perforasi ileum (
typhus abdominalis ) , invaginasi , volvulus, atau hernia inkarserata kemudian
mengalami kebocoran jahitan usus yang menyebabkan peritonitis atau
enterofistula ke kulit . Dengan bantuan nutrisi yang baik penyulit-penyulit
fatal ini dapat dihindari</span>
<br />
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-theme-font: major-bidi; mso-hansi-theme-font: major-bidi;"></span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-theme-font: major-bidi;"></span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> Rumusan Masalah</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Apa itu nutrisi
parenteral?</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Apakah indikasi
pemberian nutrisi parenteral?</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Apakah
komplikasi pemberian nutrisi parenteral?</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Apa sajakah hal
yang perlu diperhatikan dalam pemberian<span style="mso-spacerun: yes;">
</span>nutrisi parenteral?</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Bagaimanakah
cara pengelolaan nutrisi parenteral?</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Bagaimanakah
cara monitoring pasien dengan nutrisi parenteral?</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-theme-font: major-bidi; mso-hansi-theme-font: major-bidi;">1.3</span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-theme-font: major-bidi;">
</span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tujuan</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mengetahui
pengertian dari nutrisi parenteral</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mengetahui
indikasi dan juga komplikasi nutrisi parenteral</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mengetahui hal
yang perlu diperhatikan dalam pemberian nutrisi parenteral</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mengetahui
pengelolaan dan memonitoring nutrisi parenteral</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2.1 Konsep Umum
</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi Parenteral adalah suatu bentuk
pemberian nutrisi yang diberikan langsung melalui pembuluh darah tanpa melalui
saluran pencernaan. Para peneliti sebelumnya menggunakan istilah
hiperalimentasi sebagai pengganti pemberian makanan melalui intravena, dan
akhirnya diganti dengan istilah yang lebih tepat yaitu <b>Nutrisi Parenteral
Total</b>, namun demikian secara umum dipakai istilah <b>Nutrisi Parenteral </b>untuk
menggambarkan suatu pemberian makanan melalui pembuluh darah.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Berdasarkan cara pemberian Nutrisi Parenteral
dibagi atas (ASPEN, 1995) :</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi Parenteral Sentral.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi Parenteral Perifer</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: center 3.25in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span><br />
<b>Pemberian nutrisi parenteral secara rutin tidak direkomendasikan pada
kondisi-kondisi klinis sebagai berikut :</b></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pasien-pasien kanker yang sedang menjalankan terapi radiasi
dan kemoterapi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pasien-pasien preoperatif yang bukan malnutrisi berat.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pankreatitis akuta ringan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kolitis akuta.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">AIDS.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Penyakit paru yang mengalami eksaserbasi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Luka bakar.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Penyakit-penyakit berat stadium akhir (end-stage illness).</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pemberian
nutrisi hanya efektif untuk pengobatan gangguan nutrisi bukan untuk penyebab penyakitnya.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Status
nutrisi basal dan berat ringannya penyakit memegang peranan penting dalam
menentukan kapan dimulainya pemberian nutrisi parenteral. Sebagai contoh pada
orang-orang dengan malnutrisi yang nyata lebih membutuhkan penanganan dini
dibandingkan dengan orang-orang yang menderita kelaparan tanpa komplikasi.
Pasien-pasien dengan kehilangan zat nutrisi yang jelas seperti pada luka dan
fistula juga sangat rentan terhadap defisit zat nutrisi sehingga membutuhkan
nutrisi parenteral lebih awal dibandingkan dengan pasien-pasien yang kebutuhan
nutrisinya normal.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Secara
umum, pasien-pasien dewasa yang stabil harus mendapatkan dukungan nutrisi 7
sampai dengan 14 hari setelah tidak mendapatkan nutrisi yang adekuat sedangkan
pada pasien-pasien kritis, pemberian dukungan nutrisi harus dilakukan dalam
kurun waktu 5 sampai dengan 10 hari (ASPEN, 2002).</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi
Parenteral pada pasien anak-anak diberikan lebih awal dibandingkan dengan
pasien-pasien dewasa, biasanya 1 hari setelah lahir pada neonatus dan bayi
dengan berat badan lahir yang rendah, dan antara 5 sampai 7 hari bagi anak-anak
yang lebih dewasa yang tidak dapat mencukupi kebutuhan nutrisinya hanya melalui
oral maupun enteral (ASPEN, 2002; Ziegler et al, 2002).</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2.2 Indikasi Nutrisi Parenteral :</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Gangguan absorpsi makanan seperti pada fistula enterokunateus,
atresia intestinal, kolitis infektiosa, obstruksi usus halus.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kondisi dimana usus harus diistirahatkan seperti pada
pankreatitis berat, status preoperatif dengan malnutrisi berat, angina
intestinal, stenosis arteri mesenterika, diare berulang.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Gangguan motilitas usus seperti pada ileus yang
berkepanjangan, pseudo-obstruksi dan skleroderma.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kondisi dimana jalur enteral tidak dimungkinkan seperti pada
gangguan makan, muntah terus menerus, gangguan hemodinamik, hiperemesis
gravidarum.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2.3 Jenis-jenis
cairan nutrisi parenteral</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">ASERING</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<u><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span></u><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Dehidrasi (syok
hipovolemik dan asidosis) pada kondisi: gastroenteritis akut, demam berdarah
dengue (DHF), luka bakar, syok hemoragik, dehidrasi berat, trauma.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Komposisi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Setiap liter
asering mengandung:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ul type="disc">
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Na 130 mEq</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">K 4 mEq</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Cl 109 mEq</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Ca 3 mEq</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Asetat (garam) 28 mEq</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Keunggulan:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ul type="disc"><ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l12 level2 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Asetat dimetabolisme di otot, dan masih
dapat ditolelir pada pasien yang mengalami gangguan hati</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l12 level2 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pada pemberian sebelum operasi sesar, RA
mengatasi asidosis laktat lebih baik dibanding RL pada neonatus</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l12 level2 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pada kasus bedah, asetat dapat
mempertahankan suhu tubuh sentral pada anestesi dengan isofluran</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l12 level2 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mempunyai efek vasodilator</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l12 level2 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pada kasus stroke akut, penambahan MgSO4
20 % sebanyak 10 ml pada 1000 ml RA, dapat meningkatkan tonisitas larutan
infus sehingga memperkecil risiko memperburuk edema serebral</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KA-EN 1B</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:<b> </b></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Sebagai larutan awal bila status elektrolit pasien belum
diketahui, misal pada kasus emergensi (dehidrasi karena asupan oral tidak
memadai, demam)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">< 24 jam pasca operasi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Dosis lazim 500-1000 ml untuk sekali pemberian secara IV.
Kecepatan sebaiknya 300-500 ml/jam (dewasa) dan 50-100 ml/jam pada
anak-anak</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Bayi prematur atau bayi baru lahir, sebaiknya tidak diberikan
lebih dari 100 ml/jam</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KA-EN 3A &
KA-EN 3B</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l8 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Larutan rumatan nasional untuk memenuhi kebutuhan harian air
dan elektrolit dengan kandungan kalium cukup untuk mengganti ekskresi
harian, pada keadaan asupan oral terbatas</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l8 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Rumatan untuk kasus pasca operasi (> 24-48 jam)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l8 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mensuplai kalium sebesar 10 mEq/L untuk KA-EN 3A</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l8 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mensuplai kalium sebesar 20 mEq/L untuk KA-EN 3B</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KA-EN MG3</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi :</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l18 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Larutan rumatan nasional untuk memenuhi kebutuhan harian air
dan elektrolit dengan kandungan kalium cukup untuk mengganti ekskresi
harian, pada keadaan asupan oral terbatas</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l18 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Rumatan untuk kasus pasca operasi (> 24-48 jam)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l18 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mensuplai kalium 20 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l18 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Rumatan untuk kasus dimana suplemen NPC dibutuhkan 400 kcal/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KA-EN 4A</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi :</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Merupakan larutan infus rumatan untuk bayi dan anak</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tanpa kandungan kalium, sehingga dapat diberikan pada pasien
dengan berbagai kadar konsentrasi kalium serum normal</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tepat digunakan untuk dehidrasi hipertonik</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Komposisi (per
1000 ml):</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ul type="disc">
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Na 30 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">K 0 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Cl 20 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Laktat 10 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Glukosa 40 gr/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KA-EN 4B</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l16 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Merupakan larutan infus rumatan untuk bayi dan anak usia
kurang 3 tahun</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l16 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mensuplai 8 mEq/L kalium pada pasien sehingga meminimalkan
risiko hipokalemia</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l16 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tepat digunakan untuk dehidrasi hipertonik</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Komposisi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1"><ul type="circle">
<li class="MsoNormal" style="line-height: 150%; mso-list: l13 level2 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Na 30 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l13 level2 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">K 8 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l13 level2 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Cl 28 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l13 level2 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Laktat 10 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l13 level2 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Glukosa 37,5 gr/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ul>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Otsu-NS</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Untuk resusitasi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kehilangan Na > Cl, misal diare</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Sindrom yang berkaitan dengan kehilangan natrium (asidosis
diabetikum, insufisiensi adrenokortikal, luka bakar)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Otsu-RL</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l10 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Resusitasi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l10 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Suplai ion bikarbonat</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l10 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Asidosis metabolik</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">MARTOS-10</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Suplai air dan karbohidrat secara parenteral pada penderita
diabetik</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Keadaan kritis lain yang membutuhkan nutrisi eksogen seperti
tumor, infeksi berat, stres berat dan defisiensi protein</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Dosis: 0,3 gr/kg BB/jam</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mengandung 400 kcal/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">AMIPAREN</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Stres metabolik berat</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Luka bakar</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Infeksi berat</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kwasiokor</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pasca operasi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Total Parenteral Nutrition</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Dosis dewasa 100 ml selama 60 menit</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">AMINOVEL-600</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi tambahan pada gangguan saluran GI</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Penderita GI yang dipuasakan</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kebutuhan metabolik yang meningkat (misal luka bakar, trauma
dan pasca operasi)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Stres metabolik sedang</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Dosis dewasa 500 ml selama 4-6 jam (20-30 tpm)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">PAN-AMIN G</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Suplai asam amino pada hiponatremia dan stres metabolik ringan</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nitrisi dini pasca operasi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tifoid</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2.4 Pengelolaan nutrisi Parenteral</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">
</span><b><i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Kebutuhan Biologik Normal:</span></i></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Kalori: 25-30 kcal/BB/hari (mis.BB 70 kg = 1750-2100). Sumber kalori ini
terbagi berdasarkan sumbernya sebagai berkut:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>50% = karbohidrat</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>30% = protein</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>20% = lemak</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KEBUTUHAN
ENERGI</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Energi expanditure harus dihitung agar
keseimbangan nitrogen yang lebih baik dapat dicapai dan dipertahankan. Metode
yang digunakan untuk menghitung kebutuhan energi ada dua cara yaitu dengan
rumus Harris-Benedict dan indirect-calorimetry dengan expired gas analysis.<br />
Harris-Benedict mengkalkulasikan kebutuhan energy seseorang dalam keadaan
istirahat, nonstres, setelah puasa overnigt. Pada keadaan metabolic-stress,
maka harus dikalikan stress faktor.<br />
Rumus Harris - Benedict.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pr. BEE = 665 + 9,6 BB + 1,7 TB - 4,7 U</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Lk BEE = 66 + 13,7 BB + 5 TB - 6,6 U</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">BEE = K cal/ hari BB: kg TB: cm U ; Thn</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Perhitungan diatas mungkin sulit diaplikasikan
maka untuk penggunaan klinis sehari-hari nilai BEE = 25 -30 k cal/Kg/hari tidak
jauh berbeda dengan nlai yang didapat bila kita menggunakan rumus Harris
Benedict.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indirect-calorimetry.<br />
Walaupun memberi hasil yang lebih akurat tetapi oleh karena membutuhkan
pemeriksaan laboratorium, teknologi dan mahal maka jarang digunakan untuk
perhitungan sehari-hari.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KARBOHIDRAT
SEBAGAI SUMBER ENERGI</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<b><i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Kebutuhan Karbohidrat</span></i></b><i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">: </span></i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">100-200 gram/ hari. Beberapa hal yang perlu diingat tentang manfaat
karbohidrat yaitu:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 30.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo19; tab-stops: .5in; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Mengurangi katabolisme protein</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 30.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo19; tab-stops: .5in; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Mengurangi penumpukan keton bodies akibat metabolisme fat.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 30.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo19; tab-stops: .5in; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">1 gram karbohidrat<span style="mso-tab-count: 1;"> </span>= 4,1 kcal</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 30.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo19; tab-stops: .5in; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">1 gram fat<span style="mso-tab-count: 2;"> </span>= 9,3
kcal</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Jika karbohidrat hanya berasal dari cairan dektrose 5% atau 10% maka dalam
:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>1000 cc D5<span style="mso-tab-count: 1;"> </span>= 50 gram<span style="mso-tab-count: 1;"> </span>=
205 kcal</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>1000 cc D10<span style="mso-tab-count: 1;"> </span>= 100 gram<span style="mso-tab-count: 1;"> </span>=
410 kcal</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Dapat dilihat bahwa
pemenuhan kalori hanya dari larutan dextrose dengan isoosmolaritas saja tidak
cukup, dengan demikian perlu tambahan kalori dari sumber lain misalnya emulsi
lemak atau dengan karbohidrat jenis lain atau dengan konsentrasi yang lebih
tinggi. </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Kebutuhan kalori ini perlu juga disesuaikan dengan:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Jumlah kebutuhan cairan harian (maintenance)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Kebutuhan elektrolit terutama Na<sup>+</sup> dan
K<sup>+</sup></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Protein dan lemak</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Osmolaritas yang dapat ditoleransi vena perifer
yaitu < 800 mOsm.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Suatu hal yang sangat penting dalam pemberian dekstrose/glukose adalah
karbohidrat jenis ini bersifat insulin dependent. Dengen demikian pemberiannya
harus dimulai dengan konsentrasi yang rendah dan ditingkatkan secara perlahan
dan harus merata dalam 24 jam. Penghentian pemberian dextrose secara mendadak
atau tidak teratur dapat menyebabkan kadar gula darah yang turun tiba-tiba.
Penjelasan hal ini adalah sebagai berikut; saat pemberian dekstrose konsentrasi
tinggi kadar insulin juga tinggi dan saat konsentrasi pemberian diturunkan,
insulin yang tinggi <i>(overshoot insulin) </i>dapat menyebabkan hipoglikemia
akut. Bila ada ketidakmampuan insulin daat terjadi hiperglikema. R/ Triofusin
yang mengandung dextrose, fruktose dan xylitol, jarang menyebabkan
hiperglikemia ataupun tambahan insulin.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">EMULSI LEMAK
INTRAVENA</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pemberian lemak intravena selain sebagai sumber
asam lemak esensial (terutama asam linoleat) juga sebagai subtrat sumber energi
pendamping karbohidrat terutama pada kasus stress yang meningkat. Bila lemak
tidak diberikan dalam program nutrisi parenteral total bersama subtrat lainnya
maka defisiensi asam lemak rantai panjang akan terjadi kira-kira pada hari
ketujuh dengan gejala klinik bertahan sekitar empat minggu. Untuk mencegah
keadaan ini diberikan 500 ml emulsi lemak 10 ml paling sedikit 2 kali seminggu.
Asam lemak esensial berperan dalam fungsi platelet , penyembuhan luka, sintesa
prostaglandin dan immunocompetence. Oleh karena ada keuntungan bila diberikan
bersama-sama dengan glikosa sebagai sumber energi dianjurkan 30 -40 % dari
total kalori diberikan dari lemak. Ada bukti infus lemak merata 24 jam lebih
baik dan lebih dipilih dibanding pemberian intermitten. Direkomendasikan untuk
tidak memberikan > 60% kalori total diambil dari subtrat lemak. Sebagai
pegangan jangan berikan porsi lemak > 2 gr / kg BB /hari. Sebaiknya lakukan
pemeriksaan kadar triglised plasma sebelum pemberian emulsi lemak intravena
sebagai data dasar .</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Preparat emulsi lemak yang beredar ada dua
jenis, konsetrasi 10% ( 1 k cal /ml ) dan 20 % ( 2 k cal / ml ) dengan osmolalityas
270 - 340 m Osmol /L sehingga dapat diberikan melalui perifer.<br />
Kontra indikasi absolut infus emulsi lemak adalah trigliserit 500 mr/l
,Kolesterol 400 mg/l . kontraindikasi rtelatis : Trigeliderit 300 - 500 mg/l.
Kolesterol 300 - 400 mg/l ganggguan berat faal ginjal dan hepar .</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Contoh larutan lemak Misalnya R/Ivelip.</span></i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> Larutan ini tersedia dalam beberapa kemasan
dengan konsentrasi 10% dan 20%. Satu liter larutan 20% mengandung 2000 kcal
dengan osmolaritas yang rendah yaitu 270 mOsm. <i>Pada botol 250 cc yang
mengandung 50 gram lemak mengandung 500 kcal dengan osmolaritas yang sama</i>.
Larutan 20% dengan kemasan 250 cc atau 100 cc lebih disukai oleh karena mudah
dalam pengaturannya.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">·</span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">
</span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">PROTEIN / ASAM AMINO</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Selain kalori yang dipenuhi dengan karbohidrat
dan lemak , tubuh masih memerlukan asam amino untuk regenerasi sel , enzym dan
visceral protein. </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Pemberian protein untuk menjaga balance nitrogen positif, dimana protein
berfungsi untuk regenerasi sel, enzim, dan berbagai reaksi biologis dalam
tubuh. Untuk itu diperlukan 1 gram /BB/ hari. Yang paling diperlukan L-asam
amino, oleh karena proses pembentukan protein lebih cepat. <i>Perlu diingat
larutan asam amino juga mengandung karbohidrat dan elektrolit.</i> Pemberian
asam amino/protein saja tanpa diberikan kebutuhan kalori, menyebabkan asam
amino dirobah menjadi energi melalui jalur glukoneogenesis. Dengan demikian
pada pemberian asam amino yang bertujuan menjaga balance nitrogen positif,
perlu ada <i>”perlindungan”<span style="mso-spacerun: yes;"> </span></i>kalori
25 kcal tiap 1 gram asam amino. Misalnya pada pemberian asam amino/protein 50
gram, dibutuhkan 1200 kcal atau 300 gram karbohidrat. Jika asam amino bertujuan
sebagai “<i>nitrogen sparing effect”</i> dimana menjaga agar protein viscera
atau otot tidak dirobah menjadi kalori, jadi balance nitrogen sama dengan nol,
maka tidak perlu diberikan kalori.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Larutan asam amino pada
umumnya bersifat hiperosmotik, oleh karena itu pada pemberian melalui vena
perifer perlu dilakukan pengenceran misalnya dengan dekstrose, atau dipilih
asam amino dengan konsentrasi rendah. Contoh yang ada dipasaran <i>R/
Aminofusin L-600</i> dimana kandungan tiap 1000 cc sebagai berikut:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Asam amino<span style="mso-tab-count: 1;"> </span>= 50 gram</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Karbohidrat<span style="mso-tab-count: 1;"> </span>= 100 gram</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Na<sup>+</sup><span style="mso-tab-count: 2;"> </span>= 40 mmol</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>K<sup>+</sup><span style="mso-tab-count: 2;"> </span>= 30 mmol</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Osmolaritas<span style="mso-tab-count: 1;"> </span>= 1.100 mOsm</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">R/<span style="mso-spacerun: yes;"> </span>Pan Amin G</span></i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Asam amino<span style="mso-tab-count: 1;"> </span>= 27,2 gram</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Karbohidrat<span style="mso-tab-count: 1;"> </span>= 50 gram</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Na<sup>+ </sup>dan K<sup>+</sup><span style="mso-tab-count: 1;"> </span>= tidak ada</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Osmolaritas<span style="mso-tab-count: 1;"> </span>= 507 mOsm</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; mso-outline-level: 4; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">2.5 Hal yang harus diperhatikan selama pemberian</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Pemberian nutrisi
parenteral umumnya dimulai pada hari ke III pasca-bedah/trauma. Jika keadaan
membutuhkan koreksi nutrisi cepat, maka pemberian paling cepat 24 jam
pasca-trauma/bedah. Jika keadaan ragu-ragu dapat dilakukan pemeriksaan kadar
gula. Jika kadar gula darah < 200 mg/dl. pada penderita non diabetik,
nutrisi parenteral dapat dimulai.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Nutrisi parenteral tidak diberikan pada keadaan sebagai berikut:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">24 jam pasca-bedah/trauma</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">gagal napas</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">shock</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">demam tinggi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">brain death (alasan cost-benefit)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Vena perifer yang dipilih sebaiknya pada lengan, oleh karena pemberian
melalui vena tungkai bawah resiko flebitis dan trombosis vena dalam lebih
besar. Seperti telah dijelaskan diatas bahwa karbohidrat diperlukan sebagai
sumber kalori. Dalam pemenuhan kalori adalah suatu keharusan dan multak ada
dekstrose, sehingga mengurangi proses glukoneogenesis. Sebagai sumber kalori
lain adalah emulsi lemak. Jika akan diberikan emulsi lemak sebaiknya terbagi
sama banyak dalam hal jumlah kalori. Misalnya dibutuhkan jumlah kalori 1200
maka perhitungannya sebagai berikut:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>600 kcal<span style="mso-tab-count: 1;"> </span>= glukosa 150 gram</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>600 kcal<span style="mso-tab-count: 1;"> </span>= fat 70 gram</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Kombinasi ini menghindari keadaan hiperosmolar dan hiperglikemia. Pemberian
emulsi lemak harus hati-hati dan sebaiknya diberikan seminggu sekali. Lebih
baik jika dilakukan pemeriksaan fungsi hepar secara teratur.<span style="mso-spacerun: yes;"> </span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><br />
<b>Contoh:</b></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Hari I<span style="mso-tab-count: 1;"> </span>: (masa stabilisasi) cukup
diberikan kristaloid (RL atau Ringer Asetat)</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Hari II<span style="mso-tab-count: 1;"> </span>: Triofusin 500 sebanyak 1500 cc + intrafusin
3,5% 500 cc maka:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 2;"> </span>Cairan<span style="mso-tab-count: 1;"> </span>: 2000 cc</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; mso-outline-level: 5; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 2;"> </span>Asam amino<span style="mso-tab-count: 1;"> </span>: 17,5 gram</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 2;"> </span>Energi<span style="mso-tab-count: 2;"> </span>: 870 kcal</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 2;"> </span>Na<sup>+</sup><span style="mso-tab-count: 2;"> </span>: 30,8 mEq</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 2;"> </span>K<sup>+</sup><span style="mso-tab-count: 2;"> </span>: 15 mEq</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 2;"> </span>Osmolaritas<span style="mso-tab-count: 1;"> </span>: 745 mOsm</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Data ini menunjukan kekurangan natrium dan kalium. Untuk itu dapat
ditambahkan Kcl 15-20 cc (15-20 mEq) atau sesuai data laboratorium, sedangkan
natrium dapat ditambahkan NaCl 3% 200 cc yang mengandung 105 mEq Na<sup>+</sup>.
NaCl 3%=513 mEq Na<sup>+</sup>/L</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Hari III<span style="mso-tab-count: 1;"> </span>: Triofusin 500
sebanyak 1500 cc + intrafusin 3,5% 1000 cc + Ivelip<span style="mso-spacerun: yes;"> </span>10% 100 cc.</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Contoh ini dapat dimodifikasi dengan mudah sesuai kebutuhan. Perlu diingat
larutan yang mengandung dektrose harus diberikan terus-menerus. Dengan demikian
dapat dipergunakan stop-cock sehingga cairan lain yang daat diberikan selang
seling. Ketrampilan kita dalam pemberian nutrisi ini perlu disertai dengan
komposisi berbagai jenis cairan yang ada dipasaran termasuk osmolaritasnya.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KONSEP YANG PERLU DISAMAKAN PADA PARENTERAL
NUTRISI</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">1.Menggunakan vena perifer untuk cairan pekat.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Osmolritas plasma 300 mOsmol . Vena perifer
dapat menerima sampai maksimal 900 mOsmol . Makin tinggi osmolaritas (makin
hipertonis) maka makin mudah terjadi tromphlebitis, bahkan tromboembli. Untuk
cairan > 900 - 1000 mOsm, seharusnya digunakan vena setrral (vena cava,
subclavia, jugularis) dimana aliran darah besar dan cepat dapat mengencerkan
tetesan cairan NPE yang pekat hingga tidak dapat sempat merusak dinding vena.
Jika tidak tersedia kanula vena sentral maka sebaiknya dipilih dosis rendah
(larutan encer) lewat vena perifer, dengan demikian sebaiknya sebelum
memberikan cairan NPE harus memeriksa tekanan osmolaritas cairan tersebut (
tercatat disetiap botol cairan ) Vena kaki tidak boleh dipakai karena sangat
mudah deep vein trombosis dengan resiko teromboemboli yang tinggi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2. Memberikan protein tanpa kalori karbohidrat
yang cukup.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Sumber kalori yang utama dan harus selalu ada
adalah dektrose. Otak dan eritrosit mutlak memerlukan glukosa setiap saat. Jika
tidak tersedia terjadi gluneogenesis dari subtrat lain. Kalori mutlak dicukupi
lebih dulu. Diperlukan deksrose 6 gram /kg.hari (300 gr) untuk kebutuhan energi
basal 25 kcal/kg. Asam amino dibutuhkan untuk regenerasi sel, sintesis ensim
dan viseral protein. Tetapi pemberian asam amino harus dilindungi kalori, agar
asam amino tersebut tidak dibakar menjadi energi (glukoneogenesis) Tiap gram
Nitrogen harus dilindungi 150 kcal berupa karbohidrat. Satu gram Nitrogen
setara 6,25 gram protetin. Protein 50 gr memerlukan ( 50 : 6,25 ) x 150 k cal =
1200 kcal atau 300 gram karbohidrat. Kalori dari asam amino itu sendiri tidak
ikut dalam perhitungan kebutuhan kalori .</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Jangan memberikan asam amino jika kebutuhan
kalori belum dipenuhi </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">3.Tidak melakukan perawatan aseptik.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Penyulit trombplebitis karena iritasi vena
sering diikuti radang/ infeksi. Prevalensi infeksi berkisar antara 2-30 % Kuman
sering ditemukan adalah flora kulit yang terbawa masuk pada penyulit atau ganti
penutup luka infus </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2.6 Komplikasi
dan Monitoring / Pemantauan penderita </span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kemajuan
dan kemunduran keadaan umum penderita dipantau setiap harinya, termasuk
keseimbangan cairan dan elektrolitnya (bila fasilitas ada).<span style="mso-spacerun: yes;"> </span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pemberian terapi intravena menghadapkan pasien dengan berbagai
risiko komplikasi lokal atau sistemik. Komplikasi lokal seperti flebitis,
infiltrasi dan penyumbatan kanula terjadi lebih sering daripada komplikasi
sistemik yang mencakup hiperglikemia, septikemia, kelebihan beban sirkulasi dan
emboli. Oleh karena itu, pemantauan dan perawatan kateter merupakan komponen
penting dalam pemberian cairan intravena. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">1. PEMANTAUAN LOKASI PERIFER </span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Parameter yang harus dipantau meliputi: wadah
cairan, selang infus, laju pemberian, alat infus elektronik (jika digunakan), dressing,
dan tempat insersi. Frekuensi pemantauan vena perifer tergantung pada terapi
yang diresepkan, kondisi dan usia pasien. Tempat pemasangan infus harus
dipantau setiap 1 sampai 2 jam. Pasien, anak, geriatri dan kritis memerlukan
penilaian lebih sering. <sup>(1)</sup> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Wadah Larutan Infus</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Penilaian sistemik berawal dari wadah cairan
dan berlanjut ke selang infus sampai ke alat akses pembuluh darah dan tempat
insersi. Jenis larutan dan obat yang ditambahkan dicocokkan dengan instruksi
dokter dan informasi yang tercetak pada label wadah. Wadah harus diberi
label tanggal dan jam infus dipasang. Banyak cara bisa digunakan untuk memberi
label jam infus digantung dan laju infus. Stiker tidak boleh ditempel
menutupi informasi yang tercetak pada wadah. Wadah tidak boleh diberi label
dengan menulis dengan pena atau spidol, karena tinta bisa menembus plastik dan
bocor ke larutan intravena. Selanjutnya perhatikan sisa larutan dalam wadah.
Perawat menentukan berapa banyak cairan seharusnya tinggal dalam wadah
berdasarkan laju pemberian yang diinstruksikan dan waktu yang
ditunjukkan. Kita harus menyadari bahwa infus set dari berbagai pabrik
memiliki jumlah tetesan berbeda setiap ml (bisa 15 atau 20 tetes per ml). Jika
anda berikan larutan infus dengan laju 20 tetes /menit menggunakan infus set 15
tetes/ml, maka ini sesuai dengan 80 ml per jam. Tampilan juga diperhatikan;
harus jernih dan bebas dari kekeruhan dan partikel. Larutan dalam botol kaca
membutuhkan infus set dengan ventilasi atau perlu jarum udara. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Selang Infus</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Selang yang tepat harus dipasang dengan wadah
dan pompa infus. Bila digunakan infus set biasa, ketinggian wadah sebaiknya
antara 30 sampai 36 inci(76-100 cm) di atas pasien. Bila wadah ditinggikan,
laju aliran akan bertambah. Laju aliran juga bisa berubah dengan perubahan
posisi pasien. Jika tempat suntikan terletak di dekat daerah fleksi, setiap
pasien menekuk lengan atau pergelangan tangan, laju aliran berubah sehingga
menyebabkan hantaran cairan dan obat tidak tepat. Beberapa faktor lain bisa
mengubah laju aliran, sebagai berikut: </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ul type="disc">
<li class="MsoNormal" style="line-height: 150%; mso-list: l15 level1 lfo18; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Viskositas cairan : darah, emulsi lemak, atau larutan koloid
(misal albumin dan dekstran). Mungkin perlu kanula lebih besar dan hindari
vena kecil (misal vena punggung tangan)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l15 level1 lfo18; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Temperatur larutan: larutan dingin bisa menginduksi spasme
vena dan memperlambat aliran</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l15 level1 lfo18; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Infiltrasi, flebitis atau trombus </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"><br />
<br />
<b>Dressing infus</b> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Dressing dipantau untuk memastikan tetap
kering, tertutup dan utuh. Dressing yang utuh berarti pinggir-pinggirnya rapat
ke kulit. Jika dressing lembab atau integritasnya tidak baik maka harus segera
diganti. Dewasa ini ada dressing transparan dan memiliki keuntungan cepat
mendeteksi tanda dini flebitis dan infiltrasi. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tempat insersi</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Blanching</span></i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Blanching adalah keputihan mengkilat pada
tempat insersi. Ini merupakan petunjuk adanya infiltrasi, atau kebocoran cairan
ke jaringan. Jika ada kebocoran pada tempat insersi, pemasangan infus harus
diulang. Pembahasan terpisah mengenai <u>infiltrasi</u> dan <u>flebitis</u>
telah diunggah pada situs ini dan bisa diakses. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2. PEMANTAUAN KOMPLIKASI METABOLIK </span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Komplikasi metabolik terkait dengan nutrisi
parenteral bisa serius, tetapi bisa diminimalkan dengan pemantauan adekuat.
Komplikasi metabolik akut mencakup defisiensi elektrolit, khususnya kalium,
magnesium, fosfor dan kalsium. Defisiensi elektrolit ini lazim dijumpai namun
bisa dicegah dengan pemantauan adekuat terhadap kadar plasma. Begitupula halnya
dengan defisiensi trace element dan vitamin, khususnya tiamin. Kelebihan
glukosa bisa memperburuk hiperglikemia, yang diikuti dengan prognosis buruk
setelah operasi jantung, infark miokard dan stroke. Hiperglikemia juga bisa
mengganggu fungsi leukosit sehingga meningkatkan angka infeksi nosokomial.
Hipertriglieridemia bisa meningkatkan risiko steatosis hepatis (perlemakan
hati). Pemberian infus lipid selama kurun 4-8 jam bisa mengakibatkan hipertensi
pulmoner. Trigliserida serum harus diukur sebelum memulai nutrisi parenteral
dan sekali seminggu sesudahnya. Sebelum pemberian nutrisi parenteral, pasien
dengan gagal ginjal lebih rentan terhadap uremia dan pada mereka dengan deplesi
volume rentan terhadap asidosis metabolik. <sup>(2)</sup> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pada artikel ini, hanya komplikasi metabolik
akut yang disorot. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Definisi komplikasi metabolik akut yang terkait
dengan terapi cairan/nutrisi parenteral <sup>(3)</sup> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">a kadar > 2 kali nilai baseline normal
mencerminkan kelebihan nutrien. Disadur dari Buzbyetal. Am J Clin Nutr
1988;47:366–81 </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">REKOMENDASI JADWAL PEMANTAUAN PASIEN YANG
MENDAPAT NUTRISI PARENTERAL <sup>(4)</sup></span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">ALP, alkaline phosphatase; ALT, alanine
transaminase; AST, aspartate transaminase; BUN, blood urea nitrogen; CBC,
complete blood count<br />
<sup>†</sup>Periode sebelum tujuan nutrisi tercapai atau selama periode beum
stabil. ‡ Setelah stabil, tidak ada perubahan komposisi nutrien. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Hiperglikemia</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Hiperglikemia adalah petanda independen dari
prognosis buruk dalam berbagai setting klinis, termasuk sindrom koroner akut,
bedah jantung, dan persalinan. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pada pasien tanpa riwayat DM, hiperglikemia
jarang diinduksi oleh glukosa parenteral bila laju pemberian maksimum 4
mg/kg/menit. <sup>(5)</sup> Jika laju ini diterjemahkan kedalam
ml/kg/jam, ini sesuai dengan 2.4 ml glukosa 10%/kg/jam atau 3.2 ml
glukosa 7.5% /kg/jam. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Oleh karena itu, larutan parenteral yang
mengandung glukosa 7.5% (misal Aminofluid<sup>®</sup>) tidak akan
menginduksi hiperglikemia pada pasien 60 kg sepanjang laju pemberian 80
ml/jam (yang jauh di bawah maksimum 192 ml/jam). </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Risiko hiperglikemia meningkat dengan obat-obat
: kortikosteroid, gatifloxacin, atypical antipsychotics (dengan
pengecualian Abilify<sup>®</sup>), protease inhibitors, diuretik tiazid,
niacin, lithium, rifampin, phenytoin, dan obat-obat injeksi yang dicampur ke
larutan dekstrosa. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Hipertrigliseridemia </span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pasien-pasien yang mendapat TPN perlu
pemantauan kadar plasma lipid (trigliserida) yang diukur sebelum dan
selama memulai TPN. Ini memiliki kepentingan khusus pada pasien yang memiliki
risiko tinggi untuk gangguan bersihan lemak, misal hiperlipidemia,
diabetes, sepsis, atau pasien dengan gangguan fungsi ginjal atau hati, dan
pasien sakit kritis <sub>(7) </sub></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Sekarang ini ada kecenderungan meningkatkan
rasio glukosa: lemak dari 50:50 menjadi 60:40 atau bahkan 70:30 total
NPC, karena masalah-masalah yang dijumpai mengenai hiperlipidemia dan
perlemakan hati, yang kadang-kadang diikuti oleh kolestasis dan pada sebagian
pasien dapat berlanjut menjadi steatohepatitis non-alkoholik(Grade C). <sub>(8)
</sub></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kerugian-kerugian yang tepat dari perlemakan
hati dan hipertrigliseridemia belum diketahui. Pada kepustakaan dipastikan
bahwa hipertrigliseridemia merupakan faktor risiko untuk berkembangnya
arteriosklerosis dan infusi akut dari emulsi lemak yang berisi trigliserida
rantai panjang (long-chain triglyceride (LCT)) mengurangi kemampuan relaksasi
pembuluh darah. Kekhawatiran utama bahwa infus lemak bisa mengganggu
respons imun tidak didukung oleh meta-analisis terbaru. Namun, banyak ahli
menganjurkan menghindari kadar trigliserida lebih dari 5 mmol/dL, walaupun
data yang mendukung kurang. Bila kadar ini dicapai dianjurkan oleh banyak
ahli di bidang ini untuk mengurangi kandungan lemak (terutama omega-6) pada
nutrisi parenteral atau untuk sementara menghentikan lemak. Pada kasus defisit
energi tidak dianjurkan menambah glukosa lebih banyak karena ini bisa melampaui
kapasitas oksidasi pasien. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2.7 Penghentian
Nutrisi Parental</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Penghentian
nutrisi parentral harus dilakukan dengan cara bertahap untuk mencegah
terjadinya rebound hipoglkemia. Cara yang dianjurkan adalah melangkah mundur
menuju regimen hari pertama. Sementrara nutrisi enteral dinaikkan kandungan
subtratnya. Sesudah tercapai nutrisi enteral yang adekuat (2/3 dari jumlah
kebutuhan energi total) nutrisi enteral baru dapat dihentikan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">BAB III</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">PENUTUP</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">3.1 Kesimpulan</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi
Parenteral adalah suatu bentuk pemberian nutrisi yang diberikan langsung
melalui pembuluh darah tanpa melalui saluran pencernaan. Nutrisi parenteral
tidak bertujuan menggantikan kedudukan nutrisi enteral lewat usus yang normal.
Segera jika usus sudah berfungsi kembali, perlu segera dimulai nasogastric
feeding, dengan sediaan nutrisi enteral yang mudah dicerna.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi
parenteral dapat diberikan dengan aman jika megikuti pedoman yang tepat. Karena
tubuh penderita perlu waktu adapatasi terhadap perubahan mekanisme baru maka
selama penyesuaian tersebut jangan memberi beban yang berlebihan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pemantauan
yang baik terhadap terapi cairan dan nutrisi parenteral paling tidak sama
penting dengan pemilihan larutan intravena. Pencegahan dan pengenalan tanda
dini komplikasi lokal dan metabolik akan memfasilitasi kesembuhan dan
menghindari beban yang tidak perlu ditanggung oleh pasien.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">3.2 Saran</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pada
pemberian nutrisi parenteral, lakukan pemantauan yang tepat untuk menghindari
komplikasi. Jika fungsi pencernaan pasien sudah normal lebih baik mencoba untuk
memberikan nutrisi secara oral.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-27895652987412469352013-01-22T09:23:00.003-08:002013-01-22T09:23:27.472-08:00NUTRISI PARENTERAL<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><b>LATAR BELAKANG</b></span><br />
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Penderita dengan trauma yang besar, sakit berat atau sepsis mengalami
peningkatan kebutuhan energi, peningkatan katabolisme disertai kehilangan massa
tubuh yang cepat. Meskipun pemberian nutrisi konvensional mampu dengan baik
mengatasi malnutrisi biasa, bahkan hiperalimentasi ternyata gagal mengatasi
perubahan metabolik terhadap pasien-pasien seperti diatas. Penurunan berat
badan, kehilangan otot yang mengakibatkan keseimbangan nitrogen yang negatif
tetap saja terjadi, berapapun jumlah nutrisi yang diberikan. Hal ini karena
respons metabolik pada pasien sakit kritis, trauma hebat dan atau disertai
tindakan operasi dan sepsis sangat berbeda dengan dengan penderita <i>malnutrisi/starvasi</i>
(kekurangan gizi akibat intake yang kurang). Selama beberapa dekade terakhir
ini jumlah energi yang diberikan pada pasien sepsis atau sakit berat termasuk
penderita trauma dengan SIRS justru menurun, karena telah dibuktikan bahwa
kebutuhan energi pasien tidaklah jauh berbeda dengan pasien normal.
Hipermetabolisme yang timbul pada kenyataannya diimbangi dengan aktifitas fisik
yang menurun. Oleh karena itu strategi untuk mengatasi kehilangan otot dan
keseimbangan nitrogen yang negatif adalah mengatasi penyebab hipermetabolisme
dan memberi tunjangan nutrisi yang adekwat dalam kualitas bukan kwantitas.
Pemahaman penyebab terjadinya hipermetabolisme ini berarti adalah pemahaman
yang jelas dari <i>respons metabolik</i>. Respons ini terkait dengan berbagai
reaksi akibat adanya trauma, seperti neuroendokrin, imunologis dan mencakup
berbagai macam mediator inflamasi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi
seperti halnya oksigen dan cairan senantiasa dibutuhkan oleh tubuh. Penderita
yang tidak dapat makan atau tidak boleh makan harus tetap mendapat masukan
nutrisi melalui cara enteral (pipa nasogastrik) atau cara parentral
(intravena). Nutrisi parenteral tidak menggantikan fungsi alamiah usus, karena
itu hanya merupakan jalan pintas sementara sampai usus berfungsi normal
kembali. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tehnik
nutrisi parenteral memang tidak mudah dan penuh liku-liku masaalah biokimia dan
fisiologi. Juga harga relatif mahal tetapi jika digunakan dengan benar pada
penderita yang tepat, pada akhirnya akan dapat dihemat lebih banyak biaya yang
semestinya keluar untuk antibiotik dan waktu tinggal dirumah sakit .Contoh
kesalahan yang masih banyak ditemukan di rumah sakit yaitu Pemberian protein
tanpa kalori karbohidrat yang cukup dan Pemberian cairan melalui vena perifer
dimana osmolaritas cairan tersebut lebih dari 900 m Osmol yang seharusnya
melalui vena sentral.1,2 Jika krisis katabolisme kecil sedang tubuh mempunyai
cukup cadangan tidak timbul masalah apapun. Penderita dewasa mudah sehat dengan
status gisi yang baik, dapat menjalani pembedahan, puasa 5 –7 hari setelah
operasi sembuh dan pulang dengan selamat hanya dengan kerugian penurunana berat
badan. Tetapi pada kenyataannya lebih banyak penderita yang kondisi awalnya
sudah jelek ( berat badan kurang, kadar albumin < 3,5 gr/dl), untuk
penderita ini puasa pasca bedah / pasca trauma 5 – 7 hari hanya mendapat infus
elektrolit sudah cukup untuk mencetuskan hipoalbuminemia, hambatan penyenbuhan
luka , penurunan daya tahan tubuh sehingga infeksi mudah menyebar. Sehingga
banyak diantara penderita pasca bedah laparotomi karena perforasi ileum (
typhus abdominalis ) , invaginasi , volvulus, atau hernia inkarserata kemudian
mengalami kebocoran jahitan usus yang menyebabkan peritonitis atau
enterofistula ke kulit . Dengan bantuan nutrisi yang baik penyulit-penyulit
fatal ini dapat dihindari</span>
<br />
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-theme-font: major-bidi; mso-hansi-theme-font: major-bidi;"></span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-theme-font: major-bidi;"></span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> Rumusan Masalah</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Apa itu nutrisi
parenteral?</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Apakah indikasi
pemberian nutrisi parenteral?</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Apakah
komplikasi pemberian nutrisi parenteral?</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Apa sajakah hal
yang perlu diperhatikan dalam pemberian<span style="mso-spacerun: yes;">
</span>nutrisi parenteral?</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Bagaimanakah
cara pengelolaan nutrisi parenteral?</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Bagaimanakah
cara monitoring pasien dengan nutrisi parenteral?</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-theme-font: major-bidi; mso-hansi-theme-font: major-bidi;">1.3</span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-theme-font: major-bidi;">
</span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tujuan</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mengetahui
pengertian dari nutrisi parenteral</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mengetahui
indikasi dan juga komplikasi nutrisi parenteral</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mengetahui hal
yang perlu diperhatikan dalam pemberian nutrisi parenteral</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mengetahui
pengelolaan dan memonitoring nutrisi parenteral</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2.1 Konsep Umum
</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi Parenteral adalah suatu bentuk
pemberian nutrisi yang diberikan langsung melalui pembuluh darah tanpa melalui
saluran pencernaan. Para peneliti sebelumnya menggunakan istilah
hiperalimentasi sebagai pengganti pemberian makanan melalui intravena, dan
akhirnya diganti dengan istilah yang lebih tepat yaitu <b>Nutrisi Parenteral
Total</b>, namun demikian secara umum dipakai istilah <b>Nutrisi Parenteral </b>untuk
menggambarkan suatu pemberian makanan melalui pembuluh darah.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Berdasarkan cara pemberian Nutrisi Parenteral
dibagi atas (ASPEN, 1995) :</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi Parenteral Sentral.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi Parenteral Perifer</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: center 3.25in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span><br />
<b>Pemberian nutrisi parenteral secara rutin tidak direkomendasikan pada
kondisi-kondisi klinis sebagai berikut :</b></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pasien-pasien kanker yang sedang menjalankan terapi radiasi
dan kemoterapi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pasien-pasien preoperatif yang bukan malnutrisi berat.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pankreatitis akuta ringan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kolitis akuta.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">AIDS.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Penyakit paru yang mengalami eksaserbasi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Luka bakar.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l17 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Penyakit-penyakit berat stadium akhir (end-stage illness).</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pemberian
nutrisi hanya efektif untuk pengobatan gangguan nutrisi bukan untuk penyebab penyakitnya.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Status
nutrisi basal dan berat ringannya penyakit memegang peranan penting dalam
menentukan kapan dimulainya pemberian nutrisi parenteral. Sebagai contoh pada
orang-orang dengan malnutrisi yang nyata lebih membutuhkan penanganan dini
dibandingkan dengan orang-orang yang menderita kelaparan tanpa komplikasi.
Pasien-pasien dengan kehilangan zat nutrisi yang jelas seperti pada luka dan
fistula juga sangat rentan terhadap defisit zat nutrisi sehingga membutuhkan
nutrisi parenteral lebih awal dibandingkan dengan pasien-pasien yang kebutuhan
nutrisinya normal.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Secara
umum, pasien-pasien dewasa yang stabil harus mendapatkan dukungan nutrisi 7
sampai dengan 14 hari setelah tidak mendapatkan nutrisi yang adekuat sedangkan
pada pasien-pasien kritis, pemberian dukungan nutrisi harus dilakukan dalam
kurun waktu 5 sampai dengan 10 hari (ASPEN, 2002).</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi
Parenteral pada pasien anak-anak diberikan lebih awal dibandingkan dengan
pasien-pasien dewasa, biasanya 1 hari setelah lahir pada neonatus dan bayi
dengan berat badan lahir yang rendah, dan antara 5 sampai 7 hari bagi anak-anak
yang lebih dewasa yang tidak dapat mencukupi kebutuhan nutrisinya hanya melalui
oral maupun enteral (ASPEN, 2002; Ziegler et al, 2002).</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2.2 Indikasi Nutrisi Parenteral :</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Gangguan absorpsi makanan seperti pada fistula enterokunateus,
atresia intestinal, kolitis infektiosa, obstruksi usus halus.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kondisi dimana usus harus diistirahatkan seperti pada
pankreatitis berat, status preoperatif dengan malnutrisi berat, angina
intestinal, stenosis arteri mesenterika, diare berulang.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Gangguan motilitas usus seperti pada ileus yang
berkepanjangan, pseudo-obstruksi dan skleroderma.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kondisi dimana jalur enteral tidak dimungkinkan seperti pada
gangguan makan, muntah terus menerus, gangguan hemodinamik, hiperemesis
gravidarum.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2.3 Jenis-jenis
cairan nutrisi parenteral</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">ASERING</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<u><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span></u><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Dehidrasi (syok
hipovolemik dan asidosis) pada kondisi: gastroenteritis akut, demam berdarah
dengue (DHF), luka bakar, syok hemoragik, dehidrasi berat, trauma.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Komposisi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Setiap liter
asering mengandung:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ul type="disc">
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Na 130 mEq</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">K 4 mEq</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Cl 109 mEq</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Ca 3 mEq</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l5 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Asetat (garam) 28 mEq</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Keunggulan:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ul type="disc"><ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l12 level2 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Asetat dimetabolisme di otot, dan masih
dapat ditolelir pada pasien yang mengalami gangguan hati</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l12 level2 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pada pemberian sebelum operasi sesar, RA
mengatasi asidosis laktat lebih baik dibanding RL pada neonatus</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l12 level2 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pada kasus bedah, asetat dapat
mempertahankan suhu tubuh sentral pada anestesi dengan isofluran</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l12 level2 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mempunyai efek vasodilator</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l12 level2 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pada kasus stroke akut, penambahan MgSO4
20 % sebanyak 10 ml pada 1000 ml RA, dapat meningkatkan tonisitas larutan
infus sehingga memperkecil risiko memperburuk edema serebral</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KA-EN 1B</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:<b> </b></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Sebagai larutan awal bila status elektrolit pasien belum
diketahui, misal pada kasus emergensi (dehidrasi karena asupan oral tidak
memadai, demam)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">< 24 jam pasca operasi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Dosis lazim 500-1000 ml untuk sekali pemberian secara IV.
Kecepatan sebaiknya 300-500 ml/jam (dewasa) dan 50-100 ml/jam pada
anak-anak</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Bayi prematur atau bayi baru lahir, sebaiknya tidak diberikan
lebih dari 100 ml/jam</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KA-EN 3A &
KA-EN 3B</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l8 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Larutan rumatan nasional untuk memenuhi kebutuhan harian air
dan elektrolit dengan kandungan kalium cukup untuk mengganti ekskresi
harian, pada keadaan asupan oral terbatas</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l8 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Rumatan untuk kasus pasca operasi (> 24-48 jam)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l8 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mensuplai kalium sebesar 10 mEq/L untuk KA-EN 3A</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l8 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mensuplai kalium sebesar 20 mEq/L untuk KA-EN 3B</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KA-EN MG3</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi :</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l18 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Larutan rumatan nasional untuk memenuhi kebutuhan harian air
dan elektrolit dengan kandungan kalium cukup untuk mengganti ekskresi
harian, pada keadaan asupan oral terbatas</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l18 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Rumatan untuk kasus pasca operasi (> 24-48 jam)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l18 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mensuplai kalium 20 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l18 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Rumatan untuk kasus dimana suplemen NPC dibutuhkan 400 kcal/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KA-EN 4A</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi :</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Merupakan larutan infus rumatan untuk bayi dan anak</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tanpa kandungan kalium, sehingga dapat diberikan pada pasien
dengan berbagai kadar konsentrasi kalium serum normal</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tepat digunakan untuk dehidrasi hipertonik</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Komposisi (per
1000 ml):</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ul type="disc">
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Na 30 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">K 0 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Cl 20 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Laktat 10 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l6 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Glukosa 40 gr/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KA-EN 4B</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l16 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Merupakan larutan infus rumatan untuk bayi dan anak usia
kurang 3 tahun</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l16 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mensuplai 8 mEq/L kalium pada pasien sehingga meminimalkan
risiko hipokalemia</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l16 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tepat digunakan untuk dehidrasi hipertonik</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Komposisi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1"><ul type="circle">
<li class="MsoNormal" style="line-height: 150%; mso-list: l13 level2 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Na 30 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l13 level2 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">K 8 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l13 level2 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Cl 28 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l13 level2 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Laktat 10 mEq/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l13 level2 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Glukosa 37,5 gr/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ul>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Otsu-NS</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Untuk resusitasi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kehilangan Na > Cl, misal diare</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Sindrom yang berkaitan dengan kehilangan natrium (asidosis
diabetikum, insufisiensi adrenokortikal, luka bakar)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Otsu-RL</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l10 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Resusitasi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l10 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Suplai ion bikarbonat</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l10 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Asidosis metabolik</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">MARTOS-10</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Suplai air dan karbohidrat secara parenteral pada penderita
diabetik</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Keadaan kritis lain yang membutuhkan nutrisi eksogen seperti
tumor, infeksi berat, stres berat dan defisiensi protein</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Dosis: 0,3 gr/kg BB/jam</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Mengandung 400 kcal/L</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">AMIPAREN</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Stres metabolik berat</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Luka bakar</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Infeksi berat</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kwasiokor</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pasca operasi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Total Parenteral Nutrition</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l14 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Dosis dewasa 100 ml selama 60 menit</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">AMINOVEL-600</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi tambahan pada gangguan saluran GI</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Penderita GI yang dipuasakan</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kebutuhan metabolik yang meningkat (misal luka bakar, trauma
dan pasca operasi)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Stres metabolik sedang</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l7 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Dosis dewasa 500 ml selama 4-6 jam (20-30 tpm)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">PAN-AMIN G</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indikasi:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Suplai asam amino pada hiponatremia dan stres metabolik ringan</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nitrisi dini pasca operasi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l4 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tifoid</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2.4 Pengelolaan nutrisi Parenteral</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">
</span><b><i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Kebutuhan Biologik Normal:</span></i></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Kalori: 25-30 kcal/BB/hari (mis.BB 70 kg = 1750-2100). Sumber kalori ini
terbagi berdasarkan sumbernya sebagai berkut:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>50% = karbohidrat</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>30% = protein</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>20% = lemak</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KEBUTUHAN
ENERGI</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Energi expanditure harus dihitung agar
keseimbangan nitrogen yang lebih baik dapat dicapai dan dipertahankan. Metode
yang digunakan untuk menghitung kebutuhan energi ada dua cara yaitu dengan
rumus Harris-Benedict dan indirect-calorimetry dengan expired gas analysis.<br />
Harris-Benedict mengkalkulasikan kebutuhan energy seseorang dalam keadaan
istirahat, nonstres, setelah puasa overnigt. Pada keadaan metabolic-stress,
maka harus dikalikan stress faktor.<br />
Rumus Harris - Benedict.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pr. BEE = 665 + 9,6 BB + 1,7 TB - 4,7 U</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Lk BEE = 66 + 13,7 BB + 5 TB - 6,6 U</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">BEE = K cal/ hari BB: kg TB: cm U ; Thn</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Perhitungan diatas mungkin sulit diaplikasikan
maka untuk penggunaan klinis sehari-hari nilai BEE = 25 -30 k cal/Kg/hari tidak
jauh berbeda dengan nlai yang didapat bila kita menggunakan rumus Harris
Benedict.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Indirect-calorimetry.<br />
Walaupun memberi hasil yang lebih akurat tetapi oleh karena membutuhkan
pemeriksaan laboratorium, teknologi dan mahal maka jarang digunakan untuk
perhitungan sehari-hari.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: -.25in;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KARBOHIDRAT
SEBAGAI SUMBER ENERGI</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<b><i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Kebutuhan Karbohidrat</span></i></b><i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">: </span></i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">100-200 gram/ hari. Beberapa hal yang perlu diingat tentang manfaat
karbohidrat yaitu:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 30.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo19; tab-stops: .5in; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Mengurangi katabolisme protein</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 30.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo19; tab-stops: .5in; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Mengurangi penumpukan keton bodies akibat metabolisme fat.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 30.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo19; tab-stops: .5in; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">1 gram karbohidrat<span style="mso-tab-count: 1;"> </span>= 4,1 kcal</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 30.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo19; tab-stops: .5in; text-align: justify; text-indent: -.25in;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">1 gram fat<span style="mso-tab-count: 2;"> </span>= 9,3
kcal</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Jika karbohidrat hanya berasal dari cairan dektrose 5% atau 10% maka dalam
:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>1000 cc D5<span style="mso-tab-count: 1;"> </span>= 50 gram<span style="mso-tab-count: 1;"> </span>=
205 kcal</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>1000 cc D10<span style="mso-tab-count: 1;"> </span>= 100 gram<span style="mso-tab-count: 1;"> </span>=
410 kcal</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Dapat dilihat bahwa
pemenuhan kalori hanya dari larutan dextrose dengan isoosmolaritas saja tidak
cukup, dengan demikian perlu tambahan kalori dari sumber lain misalnya emulsi
lemak atau dengan karbohidrat jenis lain atau dengan konsentrasi yang lebih
tinggi. </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Kebutuhan kalori ini perlu juga disesuaikan dengan:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Jumlah kebutuhan cairan harian (maintenance)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Kebutuhan elektrolit terutama Na<sup>+</sup> dan
K<sup>+</sup></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Protein dan lemak</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Osmolaritas yang dapat ditoleransi vena perifer
yaitu < 800 mOsm.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Suatu hal yang sangat penting dalam pemberian dekstrose/glukose adalah
karbohidrat jenis ini bersifat insulin dependent. Dengen demikian pemberiannya
harus dimulai dengan konsentrasi yang rendah dan ditingkatkan secara perlahan
dan harus merata dalam 24 jam. Penghentian pemberian dextrose secara mendadak
atau tidak teratur dapat menyebabkan kadar gula darah yang turun tiba-tiba.
Penjelasan hal ini adalah sebagai berikut; saat pemberian dekstrose konsentrasi
tinggi kadar insulin juga tinggi dan saat konsentrasi pemberian diturunkan,
insulin yang tinggi <i>(overshoot insulin) </i>dapat menyebabkan hipoglikemia
akut. Bila ada ketidakmampuan insulin daat terjadi hiperglikema. R/ Triofusin
yang mengandung dextrose, fruktose dan xylitol, jarang menyebabkan
hiperglikemia ataupun tambahan insulin.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<br /></div>
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<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">·</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">EMULSI LEMAK
INTRAVENA</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pemberian lemak intravena selain sebagai sumber
asam lemak esensial (terutama asam linoleat) juga sebagai subtrat sumber energi
pendamping karbohidrat terutama pada kasus stress yang meningkat. Bila lemak
tidak diberikan dalam program nutrisi parenteral total bersama subtrat lainnya
maka defisiensi asam lemak rantai panjang akan terjadi kira-kira pada hari
ketujuh dengan gejala klinik bertahan sekitar empat minggu. Untuk mencegah
keadaan ini diberikan 500 ml emulsi lemak 10 ml paling sedikit 2 kali seminggu.
Asam lemak esensial berperan dalam fungsi platelet , penyembuhan luka, sintesa
prostaglandin dan immunocompetence. Oleh karena ada keuntungan bila diberikan
bersama-sama dengan glikosa sebagai sumber energi dianjurkan 30 -40 % dari
total kalori diberikan dari lemak. Ada bukti infus lemak merata 24 jam lebih
baik dan lebih dipilih dibanding pemberian intermitten. Direkomendasikan untuk
tidak memberikan > 60% kalori total diambil dari subtrat lemak. Sebagai
pegangan jangan berikan porsi lemak > 2 gr / kg BB /hari. Sebaiknya lakukan
pemeriksaan kadar triglised plasma sebelum pemberian emulsi lemak intravena
sebagai data dasar .</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Preparat emulsi lemak yang beredar ada dua
jenis, konsetrasi 10% ( 1 k cal /ml ) dan 20 % ( 2 k cal / ml ) dengan osmolalityas
270 - 340 m Osmol /L sehingga dapat diberikan melalui perifer.<br />
Kontra indikasi absolut infus emulsi lemak adalah trigliserit 500 mr/l
,Kolesterol 400 mg/l . kontraindikasi rtelatis : Trigeliderit 300 - 500 mg/l.
Kolesterol 300 - 400 mg/l ganggguan berat faal ginjal dan hepar .</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Contoh larutan lemak Misalnya R/Ivelip.</span></i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> Larutan ini tersedia dalam beberapa kemasan
dengan konsentrasi 10% dan 20%. Satu liter larutan 20% mengandung 2000 kcal
dengan osmolaritas yang rendah yaitu 270 mOsm. <i>Pada botol 250 cc yang
mengandung 50 gram lemak mengandung 500 kcal dengan osmolaritas yang sama</i>.
Larutan 20% dengan kemasan 250 cc atau 100 cc lebih disukai oleh karena mudah
dalam pengaturannya.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">·</span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-fareast-font-family: Symbol; mso-fareast-language: IN;">
</span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">PROTEIN / ASAM AMINO</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Selain kalori yang dipenuhi dengan karbohidrat
dan lemak , tubuh masih memerlukan asam amino untuk regenerasi sel , enzym dan
visceral protein. </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Pemberian protein untuk menjaga balance nitrogen positif, dimana protein
berfungsi untuk regenerasi sel, enzim, dan berbagai reaksi biologis dalam
tubuh. Untuk itu diperlukan 1 gram /BB/ hari. Yang paling diperlukan L-asam
amino, oleh karena proses pembentukan protein lebih cepat. <i>Perlu diingat
larutan asam amino juga mengandung karbohidrat dan elektrolit.</i> Pemberian
asam amino/protein saja tanpa diberikan kebutuhan kalori, menyebabkan asam
amino dirobah menjadi energi melalui jalur glukoneogenesis. Dengan demikian
pada pemberian asam amino yang bertujuan menjaga balance nitrogen positif,
perlu ada <i>”perlindungan”<span style="mso-spacerun: yes;"> </span></i>kalori
25 kcal tiap 1 gram asam amino. Misalnya pada pemberian asam amino/protein 50
gram, dibutuhkan 1200 kcal atau 300 gram karbohidrat. Jika asam amino bertujuan
sebagai “<i>nitrogen sparing effect”</i> dimana menjaga agar protein viscera
atau otot tidak dirobah menjadi kalori, jadi balance nitrogen sama dengan nol,
maka tidak perlu diberikan kalori.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Larutan asam amino pada
umumnya bersifat hiperosmotik, oleh karena itu pada pemberian melalui vena
perifer perlu dilakukan pengenceran misalnya dengan dekstrose, atau dipilih
asam amino dengan konsentrasi rendah. Contoh yang ada dipasaran <i>R/
Aminofusin L-600</i> dimana kandungan tiap 1000 cc sebagai berikut:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Asam amino<span style="mso-tab-count: 1;"> </span>= 50 gram</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Karbohidrat<span style="mso-tab-count: 1;"> </span>= 100 gram</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Na<sup>+</sup><span style="mso-tab-count: 2;"> </span>= 40 mmol</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>K<sup>+</sup><span style="mso-tab-count: 2;"> </span>= 30 mmol</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Osmolaritas<span style="mso-tab-count: 1;"> </span>= 1.100 mOsm</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">R/<span style="mso-spacerun: yes;"> </span>Pan Amin G</span></i><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Asam amino<span style="mso-tab-count: 1;"> </span>= 27,2 gram</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Karbohidrat<span style="mso-tab-count: 1;"> </span>= 50 gram</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Na<sup>+ </sup>dan K<sup>+</sup><span style="mso-tab-count: 1;"> </span>= tidak ada</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: .5in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Osmolaritas<span style="mso-tab-count: 1;"> </span>= 507 mOsm</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; mso-outline-level: 4; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">2.5 Hal yang harus diperhatikan selama pemberian</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Pemberian nutrisi
parenteral umumnya dimulai pada hari ke III pasca-bedah/trauma. Jika keadaan
membutuhkan koreksi nutrisi cepat, maka pemberian paling cepat 24 jam
pasca-trauma/bedah. Jika keadaan ragu-ragu dapat dilakukan pemeriksaan kadar
gula. Jika kadar gula darah < 200 mg/dl. pada penderita non diabetik,
nutrisi parenteral dapat dimulai.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Nutrisi parenteral tidak diberikan pada keadaan sebagai berikut:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">24 jam pasca-bedah/trauma</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">gagal napas</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">shock</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">demam tinggi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-font-family: "Times New Roman"; mso-ascii-theme-font: major-bidi; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: major-bidi; mso-char-type: symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">·</span></span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: Symbol; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"> </span><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">brain death (alasan cost-benefit)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Vena perifer yang dipilih sebaiknya pada lengan, oleh karena pemberian
melalui vena tungkai bawah resiko flebitis dan trombosis vena dalam lebih
besar. Seperti telah dijelaskan diatas bahwa karbohidrat diperlukan sebagai
sumber kalori. Dalam pemenuhan kalori adalah suatu keharusan dan multak ada
dekstrose, sehingga mengurangi proses glukoneogenesis. Sebagai sumber kalori
lain adalah emulsi lemak. Jika akan diberikan emulsi lemak sebaiknya terbagi
sama banyak dalam hal jumlah kalori. Misalnya dibutuhkan jumlah kalori 1200
maka perhitungannya sebagai berikut:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>600 kcal<span style="mso-tab-count: 1;"> </span>= glukosa 150 gram</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>600 kcal<span style="mso-tab-count: 1;"> </span>= fat 70 gram</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Kombinasi ini menghindari keadaan hiperosmolar dan hiperglikemia. Pemberian
emulsi lemak harus hati-hati dan sebaiknya diberikan seminggu sekali. Lebih
baik jika dilakukan pemeriksaan fungsi hepar secara teratur.<span style="mso-spacerun: yes;"> </span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><br />
<b>Contoh:</b></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Hari I<span style="mso-tab-count: 1;"> </span>: (masa stabilisasi) cukup
diberikan kristaloid (RL atau Ringer Asetat)</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 1;"> </span>Hari II<span style="mso-tab-count: 1;"> </span>: Triofusin 500 sebanyak 1500 cc + intrafusin
3,5% 500 cc maka:</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 2;"> </span>Cairan<span style="mso-tab-count: 1;"> </span>: 2000 cc</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; mso-outline-level: 5; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 2;"> </span>Asam amino<span style="mso-tab-count: 1;"> </span>: 17,5 gram</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 2;"> </span>Energi<span style="mso-tab-count: 2;"> </span>: 870 kcal</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 2;"> </span>Na<sup>+</sup><span style="mso-tab-count: 2;"> </span>: 30,8 mEq</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 2;"> </span>K<sup>+</sup><span style="mso-tab-count: 2;"> </span>: 15 mEq</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;"><span style="mso-tab-count: 2;"> </span>Osmolaritas<span style="mso-tab-count: 1;"> </span>: 745 mOsm</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Data ini menunjukan kekurangan natrium dan kalium. Untuk itu dapat
ditambahkan Kcl 15-20 cc (15-20 mEq) atau sesuai data laboratorium, sedangkan
natrium dapat ditambahkan NaCl 3% 200 cc yang mengandung 105 mEq Na<sup>+</sup>.
NaCl 3%=513 mEq Na<sup>+</sup>/L</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Hari III<span style="mso-tab-count: 1;"> </span>: Triofusin 500
sebanyak 1500 cc + intrafusin 3,5% 1000 cc + Ivelip<span style="mso-spacerun: yes;"> </span>10% 100 cc.</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-GB; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-hansi-theme-font: major-bidi;">Contoh ini dapat dimodifikasi dengan mudah sesuai kebutuhan. Perlu diingat
larutan yang mengandung dektrose harus diberikan terus-menerus. Dengan demikian
dapat dipergunakan stop-cock sehingga cairan lain yang daat diberikan selang
seling. Ketrampilan kita dalam pemberian nutrisi ini perlu disertai dengan
komposisi berbagai jenis cairan yang ada dipasaran termasuk osmolaritasnya.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">KONSEP YANG PERLU DISAMAKAN PADA PARENTERAL
NUTRISI</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">1.Menggunakan vena perifer untuk cairan pekat.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Osmolritas plasma 300 mOsmol . Vena perifer
dapat menerima sampai maksimal 900 mOsmol . Makin tinggi osmolaritas (makin
hipertonis) maka makin mudah terjadi tromphlebitis, bahkan tromboembli. Untuk
cairan > 900 - 1000 mOsm, seharusnya digunakan vena setrral (vena cava,
subclavia, jugularis) dimana aliran darah besar dan cepat dapat mengencerkan
tetesan cairan NPE yang pekat hingga tidak dapat sempat merusak dinding vena.
Jika tidak tersedia kanula vena sentral maka sebaiknya dipilih dosis rendah
(larutan encer) lewat vena perifer, dengan demikian sebaiknya sebelum
memberikan cairan NPE harus memeriksa tekanan osmolaritas cairan tersebut (
tercatat disetiap botol cairan ) Vena kaki tidak boleh dipakai karena sangat
mudah deep vein trombosis dengan resiko teromboemboli yang tinggi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2. Memberikan protein tanpa kalori karbohidrat
yang cukup.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Sumber kalori yang utama dan harus selalu ada
adalah dektrose. Otak dan eritrosit mutlak memerlukan glukosa setiap saat. Jika
tidak tersedia terjadi gluneogenesis dari subtrat lain. Kalori mutlak dicukupi
lebih dulu. Diperlukan deksrose 6 gram /kg.hari (300 gr) untuk kebutuhan energi
basal 25 kcal/kg. Asam amino dibutuhkan untuk regenerasi sel, sintesis ensim
dan viseral protein. Tetapi pemberian asam amino harus dilindungi kalori, agar
asam amino tersebut tidak dibakar menjadi energi (glukoneogenesis) Tiap gram
Nitrogen harus dilindungi 150 kcal berupa karbohidrat. Satu gram Nitrogen
setara 6,25 gram protetin. Protein 50 gr memerlukan ( 50 : 6,25 ) x 150 k cal =
1200 kcal atau 300 gram karbohidrat. Kalori dari asam amino itu sendiri tidak
ikut dalam perhitungan kebutuhan kalori .</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Jangan memberikan asam amino jika kebutuhan
kalori belum dipenuhi </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">3.Tidak melakukan perawatan aseptik.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Penyulit trombplebitis karena iritasi vena
sering diikuti radang/ infeksi. Prevalensi infeksi berkisar antara 2-30 % Kuman
sering ditemukan adalah flora kulit yang terbawa masuk pada penyulit atau ganti
penutup luka infus </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2.6 Komplikasi
dan Monitoring / Pemantauan penderita </span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kemajuan
dan kemunduran keadaan umum penderita dipantau setiap harinya, termasuk
keseimbangan cairan dan elektrolitnya (bila fasilitas ada).<span style="mso-spacerun: yes;"> </span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pemberian terapi intravena menghadapkan pasien dengan berbagai
risiko komplikasi lokal atau sistemik. Komplikasi lokal seperti flebitis,
infiltrasi dan penyumbatan kanula terjadi lebih sering daripada komplikasi
sistemik yang mencakup hiperglikemia, septikemia, kelebihan beban sirkulasi dan
emboli. Oleh karena itu, pemantauan dan perawatan kateter merupakan komponen
penting dalam pemberian cairan intravena. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">1. PEMANTAUAN LOKASI PERIFER </span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Parameter yang harus dipantau meliputi: wadah
cairan, selang infus, laju pemberian, alat infus elektronik (jika digunakan), dressing,
dan tempat insersi. Frekuensi pemantauan vena perifer tergantung pada terapi
yang diresepkan, kondisi dan usia pasien. Tempat pemasangan infus harus
dipantau setiap 1 sampai 2 jam. Pasien, anak, geriatri dan kritis memerlukan
penilaian lebih sering. <sup>(1)</sup> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Wadah Larutan Infus</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Penilaian sistemik berawal dari wadah cairan
dan berlanjut ke selang infus sampai ke alat akses pembuluh darah dan tempat
insersi. Jenis larutan dan obat yang ditambahkan dicocokkan dengan instruksi
dokter dan informasi yang tercetak pada label wadah. Wadah harus diberi
label tanggal dan jam infus dipasang. Banyak cara bisa digunakan untuk memberi
label jam infus digantung dan laju infus. Stiker tidak boleh ditempel
menutupi informasi yang tercetak pada wadah. Wadah tidak boleh diberi label
dengan menulis dengan pena atau spidol, karena tinta bisa menembus plastik dan
bocor ke larutan intravena. Selanjutnya perhatikan sisa larutan dalam wadah.
Perawat menentukan berapa banyak cairan seharusnya tinggal dalam wadah
berdasarkan laju pemberian yang diinstruksikan dan waktu yang
ditunjukkan. Kita harus menyadari bahwa infus set dari berbagai pabrik
memiliki jumlah tetesan berbeda setiap ml (bisa 15 atau 20 tetes per ml). Jika
anda berikan larutan infus dengan laju 20 tetes /menit menggunakan infus set 15
tetes/ml, maka ini sesuai dengan 80 ml per jam. Tampilan juga diperhatikan;
harus jernih dan bebas dari kekeruhan dan partikel. Larutan dalam botol kaca
membutuhkan infus set dengan ventilasi atau perlu jarum udara. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Selang Infus</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Selang yang tepat harus dipasang dengan wadah
dan pompa infus. Bila digunakan infus set biasa, ketinggian wadah sebaiknya
antara 30 sampai 36 inci(76-100 cm) di atas pasien. Bila wadah ditinggikan,
laju aliran akan bertambah. Laju aliran juga bisa berubah dengan perubahan
posisi pasien. Jika tempat suntikan terletak di dekat daerah fleksi, setiap
pasien menekuk lengan atau pergelangan tangan, laju aliran berubah sehingga
menyebabkan hantaran cairan dan obat tidak tepat. Beberapa faktor lain bisa
mengubah laju aliran, sebagai berikut: </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ul type="disc">
<li class="MsoNormal" style="line-height: 150%; mso-list: l15 level1 lfo18; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Viskositas cairan : darah, emulsi lemak, atau larutan koloid
(misal albumin dan dekstran). Mungkin perlu kanula lebih besar dan hindari
vena kecil (misal vena punggung tangan)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l15 level1 lfo18; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Temperatur larutan: larutan dingin bisa menginduksi spasme
vena dan memperlambat aliran</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l15 level1 lfo18; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Infiltrasi, flebitis atau trombus </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"><br />
<br />
<b>Dressing infus</b> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Dressing dipantau untuk memastikan tetap
kering, tertutup dan utuh. Dressing yang utuh berarti pinggir-pinggirnya rapat
ke kulit. Jika dressing lembab atau integritasnya tidak baik maka harus segera
diganti. Dewasa ini ada dressing transparan dan memiliki keuntungan cepat
mendeteksi tanda dini flebitis dan infiltrasi. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Tempat insersi</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Blanching</span></i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Blanching adalah keputihan mengkilat pada
tempat insersi. Ini merupakan petunjuk adanya infiltrasi, atau kebocoran cairan
ke jaringan. Jika ada kebocoran pada tempat insersi, pemasangan infus harus
diulang. Pembahasan terpisah mengenai <u>infiltrasi</u> dan <u>flebitis</u>
telah diunggah pada situs ini dan bisa diakses. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2. PEMANTAUAN KOMPLIKASI METABOLIK </span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Komplikasi metabolik terkait dengan nutrisi
parenteral bisa serius, tetapi bisa diminimalkan dengan pemantauan adekuat.
Komplikasi metabolik akut mencakup defisiensi elektrolit, khususnya kalium,
magnesium, fosfor dan kalsium. Defisiensi elektrolit ini lazim dijumpai namun
bisa dicegah dengan pemantauan adekuat terhadap kadar plasma. Begitupula halnya
dengan defisiensi trace element dan vitamin, khususnya tiamin. Kelebihan
glukosa bisa memperburuk hiperglikemia, yang diikuti dengan prognosis buruk
setelah operasi jantung, infark miokard dan stroke. Hiperglikemia juga bisa
mengganggu fungsi leukosit sehingga meningkatkan angka infeksi nosokomial.
Hipertriglieridemia bisa meningkatkan risiko steatosis hepatis (perlemakan
hati). Pemberian infus lipid selama kurun 4-8 jam bisa mengakibatkan hipertensi
pulmoner. Trigliserida serum harus diukur sebelum memulai nutrisi parenteral
dan sekali seminggu sesudahnya. Sebelum pemberian nutrisi parenteral, pasien
dengan gagal ginjal lebih rentan terhadap uremia dan pada mereka dengan deplesi
volume rentan terhadap asidosis metabolik. <sup>(2)</sup> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pada artikel ini, hanya komplikasi metabolik
akut yang disorot. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Definisi komplikasi metabolik akut yang terkait
dengan terapi cairan/nutrisi parenteral <sup>(3)</sup> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">a kadar > 2 kali nilai baseline normal
mencerminkan kelebihan nutrien. Disadur dari Buzbyetal. Am J Clin Nutr
1988;47:366–81 </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">REKOMENDASI JADWAL PEMANTAUAN PASIEN YANG
MENDAPAT NUTRISI PARENTERAL <sup>(4)</sup></span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">ALP, alkaline phosphatase; ALT, alanine
transaminase; AST, aspartate transaminase; BUN, blood urea nitrogen; CBC,
complete blood count<br />
<sup>†</sup>Periode sebelum tujuan nutrisi tercapai atau selama periode beum
stabil. ‡ Setelah stabil, tidak ada perubahan komposisi nutrien. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Hiperglikemia</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;"> </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Hiperglikemia adalah petanda independen dari
prognosis buruk dalam berbagai setting klinis, termasuk sindrom koroner akut,
bedah jantung, dan persalinan. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pada pasien tanpa riwayat DM, hiperglikemia
jarang diinduksi oleh glukosa parenteral bila laju pemberian maksimum 4
mg/kg/menit. <sup>(5)</sup> Jika laju ini diterjemahkan kedalam
ml/kg/jam, ini sesuai dengan 2.4 ml glukosa 10%/kg/jam atau 3.2 ml
glukosa 7.5% /kg/jam. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Oleh karena itu, larutan parenteral yang
mengandung glukosa 7.5% (misal Aminofluid<sup>®</sup>) tidak akan
menginduksi hiperglikemia pada pasien 60 kg sepanjang laju pemberian 80
ml/jam (yang jauh di bawah maksimum 192 ml/jam). </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Risiko hiperglikemia meningkat dengan obat-obat
: kortikosteroid, gatifloxacin, atypical antipsychotics (dengan
pengecualian Abilify<sup>®</sup>), protease inhibitors, diuretik tiazid,
niacin, lithium, rifampin, phenytoin, dan obat-obat injeksi yang dicampur ke
larutan dekstrosa. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Hipertrigliseridemia </span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pasien-pasien yang mendapat TPN perlu
pemantauan kadar plasma lipid (trigliserida) yang diukur sebelum dan
selama memulai TPN. Ini memiliki kepentingan khusus pada pasien yang memiliki
risiko tinggi untuk gangguan bersihan lemak, misal hiperlipidemia,
diabetes, sepsis, atau pasien dengan gangguan fungsi ginjal atau hati, dan
pasien sakit kritis <sub>(7) </sub></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Sekarang ini ada kecenderungan meningkatkan
rasio glukosa: lemak dari 50:50 menjadi 60:40 atau bahkan 70:30 total
NPC, karena masalah-masalah yang dijumpai mengenai hiperlipidemia dan
perlemakan hati, yang kadang-kadang diikuti oleh kolestasis dan pada sebagian
pasien dapat berlanjut menjadi steatohepatitis non-alkoholik(Grade C). <sub>(8)
</sub></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Kerugian-kerugian yang tepat dari perlemakan
hati dan hipertrigliseridemia belum diketahui. Pada kepustakaan dipastikan
bahwa hipertrigliseridemia merupakan faktor risiko untuk berkembangnya
arteriosklerosis dan infusi akut dari emulsi lemak yang berisi trigliserida
rantai panjang (long-chain triglyceride (LCT)) mengurangi kemampuan relaksasi
pembuluh darah. Kekhawatiran utama bahwa infus lemak bisa mengganggu
respons imun tidak didukung oleh meta-analisis terbaru. Namun, banyak ahli
menganjurkan menghindari kadar trigliserida lebih dari 5 mmol/dL, walaupun
data yang mendukung kurang. Bila kadar ini dicapai dianjurkan oleh banyak
ahli di bidang ini untuk mengurangi kandungan lemak (terutama omega-6) pada
nutrisi parenteral atau untuk sementara menghentikan lemak. Pada kasus defisit
energi tidak dianjurkan menambah glukosa lebih banyak karena ini bisa melampaui
kapasitas oksidasi pasien. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">2.7 Penghentian
Nutrisi Parental</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Penghentian
nutrisi parentral harus dilakukan dengan cara bertahap untuk mencegah
terjadinya rebound hipoglkemia. Cara yang dianjurkan adalah melangkah mundur
menuju regimen hari pertama. Sementrara nutrisi enteral dinaikkan kandungan
subtratnya. Sesudah tercapai nutrisi enteral yang adekuat (2/3 dari jumlah
kebutuhan energi total) nutrisi enteral baru dapat dihentikan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">BAB III</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">PENUTUP</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi
Parenteral adalah suatu bentuk pemberian nutrisi yang diberikan langsung
melalui pembuluh darah tanpa melalui saluran pencernaan. Nutrisi parenteral
tidak bertujuan menggantikan kedudukan nutrisi enteral lewat usus yang normal.
Segera jika usus sudah berfungsi kembali, perlu segera dimulai nasogastric
feeding, dengan sediaan nutrisi enteral yang mudah dicerna.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Nutrisi
parenteral dapat diberikan dengan aman jika megikuti pedoman yang tepat. Karena
tubuh penderita perlu waktu adapatasi terhadap perubahan mekanisme baru maka
selama penyesuaian tersebut jangan memberi beban yang berlebihan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pemantauan
yang baik terhadap terapi cairan dan nutrisi parenteral paling tidak sama
penting dengan pemilihan larutan intravena. Pencegahan dan pengenalan tanda
dini komplikasi lokal dan metabolik akan memfasilitasi kesembuhan dan
menghindari beban yang tidak perlu ditanggung oleh pasien.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">3.2 Saran</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-bidi;">Pada
pemberian nutrisi parenteral, lakukan pemantauan yang tepat untuk menghindari
komplikasi. Jika fungsi pencernaan pasien sudah normal lebih baik mencoba untuk
memberikan nutrisi secara oral.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
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Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-19452681088301817862013-01-22T09:15:00.000-08:002013-01-22T09:18:58.191-08:00ANALGESIK<div dir="ltr" style="text-align: left;" trbidi="on">
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<![endif]--><b>ANALGESIK </b>adalah obat yang dapat mengurangi rasa nyeri dan akhirnya akan memberikan rasa nyaman pada orang yang menderita.<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Nyeri merupakan suatu pengalaman sensorik dan motorik yang tidak menyenangkan,
berhubungan dengan adanya potensi kerusakan jaringan atau kondisi yang
menggambarkan kerusakan tersebut. Sedangkan
<b>antipiretik</b> adalah obat yang dapat menurunkan demam (suhu tubuh yang
tinggi). Pada umumnya (sekitar 90%) analgesik mempunyai efek antipiretik.<br />
<b>Gejala Nyeri </b>dapat digambarkan sebagai rasa benda tajam yang menusuk,
pusing, panas seperti rasa terbakar, menyengat, pedih, nyeri yang merambat,
rasa nyeri yang hilang – timbul dan berbeda tempat nyeri.</span><br />
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><b>Apa yang menyebab kan nyeri ? <br />
</b>Nyeri terjadi jika organ tubuh, otot, atau kulit terluka oleh benturan,
penyakit, keram, atau bengkak. Rangsangan penimbul nyeri umumnya punya
kemampuan menyebabkan sel-sel melepaskan enzim proteolitik (pengurai protein)
dan polipeptida yang merangsang ujung saraf yang kemudian menimbulkan impuls
nyeri. Senyawa kimia dalam tubuh yang disebut prostaglandin beraksi membuat
ujung saraf menjadi lebih sensitif terhadap rangsangan nyeri oleh polipeptida
ini.</span></div>
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Penanganan Nyeri <br />
</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Obat-obat yang dapat mengurangi
nyeri antara lain:</span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="mso-cellspacing: 0in; mso-padding-alt: 0in 0in 0in 0in; mso-yfti-tbllook: 1184; width: 100%px;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="padding: 0in 0in 0in 0in; width: 4.0%;" width="4%"></td>
<td style="padding: 0in 0in 0in 0in; width: 96.0%;" width="96%"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Golongan
Para amino fenol à asetaminofen (Parasetamol ), fenasetin</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1;">
<td style="padding: 0in 0in 0in 0in;"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<br /></div>
</td>
<td style="padding: 0in 0in 0in 0in;"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Golongan
Pirazolon à dipiron (antalgin)</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 2; mso-yfti-lastrow: yes;">
<td style="padding: 0in 0in 0in 0in;"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">· </span></div>
</td>
<td style="padding: 0in 0in 0in 0in;"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Derivat
Asam Salisilat à Aspirin<span style="color: #3333cd;">, </span><span style="color: black;">Benorilat, Diflunisal, Salsalat</span></span></div>
</td>
</tr>
</tbody></table>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="mso-cellspacing: 0in; mso-padding-alt: 0in 0in 0in 0in; mso-yfti-tbllook: 1184; width: 100%px;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="padding: 0in 0in 0in 0in; width: 5.0%;" valign="top" width="5%"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">1</span></div>
</td>
<td style="padding: 0in 0in 0in 0in; width: 95.0%;" width="95%"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Derivat.As.Fenamat
à As.Mefenamat, Meklofenamat</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1;">
<td style="padding: 0in 0in 0in 0in;" valign="top"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">2</span></div>
</td>
<td style="padding: 0in 0in 0in 0in;"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Derivat
Asam Propionat à As.Tiaprofenat, Fenbufen, Flurbiprofen, Ibuprofen,
Ketoprofen, Naproksen</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 2; mso-yfti-lastrow: yes;">
<td style="padding: 0in 0in 0in 0in;" valign="top"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">3</span></div>
</td>
<td style="padding: 0in 0in 0in 0in;"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Derivat
As.Fenilasetat à Diklofenak, Fenklofenak</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-no-proof: yes;"></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
</div>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-47888948992378684212013-01-22T09:05:00.004-08:002013-01-22T09:11:52.574-08:00ALKALOID<div dir="ltr" style="text-align: left;" trbidi="on">
<b>ALKALOID</b><br />
<b> </b>Pada waktu yang lampau sebagian besar sumber alkaloid adalah pada tanaman berbunga, angiosperma (Familia Leguminoceae, Papavraceae, Ranunculaceae, Rubiaceae, Solanaceae,Berberidaceae) dan juga pada tumbuhan monokotil (Familia Solanaceae dan Liliaceae). Pada tahun-tahun berikutnya penemuan sejumlah besar alkaloid terdapat pada hewan, serangga, organisme laut, mikroorganisme dan tanaman rendah. Karena alkaloid sebagai suatu kelompok senyawa yang terdapat sebagian besar pada tanaman berbunga, maka para ilmuwan sangat tertarik pada sistematika aturan tanaman. Kelompok tertentu alkaloid dihubungkan dengan famili atau genera tanaman tertentu.
Dalam dunia medis dan kimia organik, istilah alkaloid telah lama menjadi bagian penting dan tak terpisahkan dalam penelitian yang telah dilakukan selama ini, baik untuk mencari senyawa alkaloid baru ataupun untuk penelusuran bioaktifitas. Senyawa alkaloid merupakan senyawa organik terbanyak ditemukan di alam. Hampir seluruh alkaloid berasal dari tumbuhan dan tersebar luas dalam berbagai jenis tumbuhan. Secara organoleptik, daun-daunan yang berasa sepat dan pahit, biasanya teridentifikasi mengandung alkaloid. Selain daun-daunan, senyawa alkaloid dapat ditemukan pada akar, biji, ranting, dan kulit kayu. Berdasarkan literatur, diketahui bahwa hampir semua alkaloid di alam mempunyai keaktifan biologis dan memberikan efek fisiologis tertentu pada mahluk hidup. Sehingga tidaklah mengherankan jika manusia dari dulu sampai sekarang selalu mencari obat-obatan dari berbagai ekstrak tumbuhan. Fungsi alkaloid sendiri dalam tumbuhan sejauh ini belum diketahui secara pasti, beberapa ahli pernah mengungkapkan bahwa alkaloid diperkirakan sebagai pelindung tumbuhan dari serangan hama dan penyakit, pengatur tumbuh, atau sebagai basa mineral untuk mempertahankan keseimbangan ion.
Alkaloid secara umum mengandung paling sedikit satu buah atom nitrogen yang bersifat basa dan merupakan bagian dari cincin heterosiklik. Kebanyakan alkaloid berbentuk padatan kristal dengan titik lebur tertentu atau mempunyai kisaran dekomposisi. Alkaloid dapat juga berbentuk amorf atau cairan. Dewasa ini telah ribuan senyawa alkaloid yang ditemukan dan dengan berbagai variasi struktur yang unik, mulai dari yang paling sederhana sampai yang paling sulit.
Dari segi biogenetik, alkaloid diketahui berasal dari sejumlah kecil asam amino yaitu ornitin dan lisin yang menurunkan alkaloid alisiklik, fenilalanin dan tirosin yang menurunkan alkaloid jenis isokuinolin, dan triftopan yang menurunkan alkaloid indol. Reaksi utama yang mendasari biosintesis senyawa alkaloid adalah reaksi mannich antara suatu aldehida dan suatu amina primer dan sekunder, dan suatu senyawa enol atau fenol. Biosintesis alkaloid juga melibatkan reaksi rangkap oksidatif fenol dan metilasi. Jalur poliketida dan jalur mevalonat juga ditemukan dalam biosintesis alkaloid.
Berikut adalah beberapa contoh senyawa alkaloid yang telah umum dikenal dalam bidang farmakologi :
Senyawa Alkaloid
(Nama Trivial) Aktivitas Biologi
Nikotin Stimulan pada syaraf otonom
Morfin Analgesik
Kodein Analgesik, obat batuk
Atropin Obat tetes mata
Skopolamin Sedatif menjelang operasi
Kokain Analgesik
Piperin Antifeedant (bioinsektisida)
Quinin Obat malaria
Vinkristin Obat kanker
Ergotamin Analgesik pada migrain
Reserpin Pengobatan simptomatis disfungsi ereksi
Mitraginin Analgesik dan antitusif
Vinblastin Anti neoplastik, obat kanker
Saponin Antibakteri<br />
• Golongan Piridina: piperine, coniine, trigonelline, arecoline, arecaidine, guvacine, cytisine, lobeline, nikotina, anabasine, sparteine, pelletierine.<br />
• Golongan Pyrrolidine: hygrine, cuscohygrine, nikotina<br />
• Golongan Tropane: atropine, kokaina, ecgonine, scopolamine, catuabine<br />
• Golongan Kuinolina: kuinina, kuinidina, dihidrokuinina, dihidrokuinidina, strychnine, brucine, veratrine, cevadine<br />
• Golongan Isokuinolina: alkaloid-alkaloid opium (papaverine, narcotine, narceine), sanguinarine, hydrastine, berberine, emetine, berbamine, oxyacanthine<br />
• Alkaloid Fenantrena: alkaloid-alkaloid opium (morfin, codeine, thebaine)<br />
• Golongan Phenethylamine: mescaline, ephedrine, dopamin<br />
• Golongan Indola:
o Tryptamines: serotonin, DMT, 5-MeO-DMT, bufotenine, psilocybin
o Ergolines (alkaloid-alkaloid dari ergot ): ergine, ergotamine, lysergic acid
o Beta-carboline: harmine, harmaline, tetrahydroharmine
o Yohimbans: reserpine, yohimbine
o Alkaloid Vinca: vinblastine, vincristine
o Alkaloid Kratom (Mitragyna speciosa): mitragynine, 7-hydroxymitragynine
o Alkaloid Tabernanthe iboga: ibogaine, voacangine, coronaridine
o Alkaloid Strychnos nux-vomica: strychnine, brucine<br />
• Golongan Purine:
o Xantina: Kafein, teobromina, theophylline<br />
• Golongan Terpenoid:
o Alkaloid Aconitum: aconitine
o Alkaloid Steroid (yang bertulang punggung steroid pada struktur yang bernitrogen):
Solanum (contoh: kentang dan alkaloid tomat) (solanidine, solanine, chaconine)
Alkaloid Veratrum (veratramine, cyclopamine, cycloposine, jervine, muldamine)[2]
Alkaloid Salamander berapi (samandarin)
lainnya: conessine<br />
• Senyawa ammonium quaternary s: muscarine, choline, neurine<br />
• Lain-lainnya: capsaicin, cynarin, phytolaccine, phytolaccotoxin
</div>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-25499887641412862572013-01-20T19:08:00.002-08:002013-01-20T19:11:17.434-08:00LOCK A FOLDER<div dir="ltr" style="text-align: left;" trbidi="on">
Applikasi lock folder buat hidden nin data pribadi kamu dengan APP dan password yang gak ingin orang lain tau saat buka buka PC mu<br />
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Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-59103757906677910662013-01-20T09:29:00.000-08:002013-01-20T09:31:03.266-08:00MACAM MACAM LARUTAN<div dir="ltr" style="text-align: left;" trbidi="on">
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<br />
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="PT-BR" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: PT-BR; mso-fareast-font-family: "Times New Roman";"><b>MACAM MACAM SEDIAAN LARUTAN</b> </span><br />
<span lang="PT-BR" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: PT-BR; mso-fareast-font-family: "Times New Roman";">Bentuk sediaan larutan berdasarkan
cara pemberiannya dibedakan atas :</span></div>
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<b><span lang="PT-BR" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: PT-BR; mso-fareast-font-family: "Times New Roman";">Larutan oral </span></b></div>
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="PT-BR" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: PT-BR; mso-fareast-font-family: "Times New Roman";">Yaitu sediaan cair yang dibuat untuk
pemberian oral, mengandung satu atau lebih zat dengan atau tanpa bahan
pengaroma, pemanis atau pewarna yang larut dalam air atau campuran
cosolvent-air.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 117.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -117.0pt;">
<span lang="PT-BR" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: PT-BR; mso-fareast-font-family: "Times New Roman";">1. Potiones
(obat minum)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="PT-BR" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: PT-BR; mso-fareast-font-family: "Times New Roman";">Adalah
solutio yang dimaksudkan untuk pemakaian dalam (peroral). Selain berbentuk
larutan potio dapat juga berbentuk emulsi atau suspensi.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 117.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -117.0pt;">
<span lang="PT-BR" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: PT-BR; mso-fareast-font-family: "Times New Roman";">2. Sirup </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="PT-BR" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: PT-BR; mso-fareast-font-family: "Times New Roman";">Ada 3 macam
sirup yaitu :</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.75in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">a. Sirup
simpleks, mengandung 65 % gula dalam larutan nipagin 0,25 % b/v.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">b. Sirup obat,
mengandung satu atau lebih jenis obat dengan atau tanpa zat tambahan digunakan
untuk pengobatan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">c. Sirup
pewangi, tidak mengandung obat tetapi mengandung zat pewangi atau penyedap
lain. Penambahan sirup ini bertujuan untuk menutup rasa atau bau obat yang
tidak enak.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 117.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -117.0pt;">
<span lang="PT-BR" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: PT-BR; mso-fareast-font-family: "Times New Roman";">3. Elixir</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="PT-BR" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: PT-BR; mso-fareast-font-family: "Times New Roman";">Adalah
sediaan larutan yang mengandung bahan obat dan bahan tambahan (pemanis,
pengawet, pewarna dan pewangi) sehingga memiliki bau dan rasa yang sedap dan
sebagai pelarut digunakan campuran air – etanol.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="PT-BR" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: PT-BR; mso-fareast-font-family: "Times New Roman";">Disini
etanol berfungsi mempertinggi kelarutan obat pada elixir dapat pula ditmbahkan
glicerol, sorbitol atau propilenglikol. Sedangkan untuk pengganti gula bisa
digunakan sirup gula.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 117.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -117.0pt;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">4. Netralisasi,
saturatio dan potio effervescent.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">a. Netralisasi
adalah obat minum yang dibuat dengan mencampurkan bagian asam dan bagian basa
sampai reaksi selesai dan larutan bersifat netral. Contohnya : solutio citratis
magnesici, amygdalas ammonicus.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">b. Saturatio
adalah Obat minum yang dibuat dengan mereaksikan asam dengan basa tetapi gas
yang terjadi ditahan dalam wadah sehingga larutan jenuh dengan gas. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.75in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">c. Potio effervescent adalah
Saturatio yang CO<sub>2</sub> nya lewat jenuh.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 117.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -117.0pt;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">5. Guttae
(drops) </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Guttae / obat
tetes adalah sediaan cair berupa larutan, emulsi atau suspensi, apabila tidak
dinyatakan lain maka dimaksudkan untuk obat dalam. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">6.Dll</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<b><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Larutan topikal </span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Larutan topikal adalah larutan yang
biasanya mengandung air tetapi seringkali juga pelarut lain, misalnya etanol
untuk penggunaan topikal pada kulit dan untuk penggunaan topikal pada mukosa
mulut. Larutan topikal yang berupa suspensi disebut lotio. Sediaan-sediaan
termasuk larutan topikal :</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">1. Collyrium</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Adalah sediaan
berupa larutan steril, jernih, bebas pirogen, isotonis, digunakan untuk
membersihkan mata. Dapat ditambahkan zat dapar dan zat pengawet.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">2. Guttae
Ophthalmicae </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Tetes mata
adalah larutan steril bebas partikel asing merupakan sediaan yang dibuat dan
dikemas sedemikian rupa hingga sesuai digunakan pada mata. Tetes mata juga
tersedia dalam bentuk suspensi, partikel halus dalam bentuk termikronisasi agar
tidak menimbulkan iritasi atau goresan pada kornea.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">3. Gargarisma </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Gargarisma /
obat kumur mulut adalah sediaan berupa larutan umumnya dalam keadaan pekat yang
harus diencerkan dahulu sebelum digunakan. Dimaksudkan untuk digunakan sebagai
pencegahan atau pengobatan infeksi tenggorokan. Contohnya : Betadin gargle.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">4. Guttae Oris</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Tetes mulut
adalah Obat tetes yang digunakan untuk mulut dengan cara mengencerkan lebih
dahulu dengan air untuk dikumur-kumur, tidak untuk ditelan.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">5. Guttae
Nasalis</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Tetes hidung
adalah obat yang digunakan untuk hidung dengan cara meneteskan obat kedalam
rongga hidung, dapat mengandung zat pensuspensi, pendapar dan pengawet. Minyak
lemak atau minyak mineral tidak boleh digunakan sebagai cairan pembawa. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">6. Inhalation </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Sediaan yang
dimaksudkan untuk disedot oleh hidung atau mulut, atau disemprotkan dalam
bentuk kabut kedalam saluran pernafasan. Tetesan butiran kabut harus seragam dan
sangat halus sehingga dapat mencapai bronkhioli.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">7. Injectiones
/ Obat suntik</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Injeksi adalah
sediaan steril berupa larutan, emulsi atau suspensi atau serbuk yang harus
dilarutkan atau disuspensikan lebih dahulu sebelum digunakan, yang disuntikan
dengan cara merobek jaringan kedalam kulit atau melalui kulit atau selaput
lendir.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">8. Lavement /
Enema / Clysma</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Cairan yang
pemakaiannya per rectum / colon yang gunanya untuk membersihkan atau
menghasilkan efek terapi setempat atau sistemik. Enema yang digunakan untuk
membersihkan atau penolong pada sembelit atau pembersih feces sebelum operasi,
tidak boleh mengandung zat lendir. Selain untuk membersihkan enema juga
berfungsi sebagai karminativa, emolient, diagnostic, sedativa, anthelmintic dan
lain-lain. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">9. Douche</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Adalah larutan
dalam air yang dimaksudkan dengan suatu alat kedalam vagina, baik untuk
pengobatan maupun untuk membersihkan. Karena larutan ini mengandung bahan obat
atau antiseptik. Contoh : Betadin Vagina Douche. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">10. Epithema /
Obat kompres </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Adalah cairan
yang dipakai untuk mendatangkan rasa dingin pada tempat-tempat yang sakit dan
panas karena radang atau berdasarkan sifat perbedaan tekanan osmose digunakan
untuk mngeringkan luka bernanah. Contoh : Rivanol. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.5in;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">11. Litus Oris </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Oles bibir
adalah cairan agak kental dan pemakaiannya secara disapukan dalam mulut. Contoh
larutan 10 % Borax dalam gliserin.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;">
<b><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Hal-hal yang perlu diperhatikan pada
pembuatan obat tetes mata :</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Nilai isotonisitas</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Pendaparan </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Pengawet </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Pengental</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span lang="SV" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Pengkhelat</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.75in;">
<span lang="NO-BOK" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: NO-BOK; mso-fareast-font-family: "Times New Roman";">Sumber :</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span lang="NO-BOK" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: NO-BOK; mso-fareast-font-family: "Times New Roman";">Lahman. L, dkk.1994. <i>Teori dan Praktek
Farmasi Industri</i>. </span><span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">Edisi III. Jakarta : UI Press.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span lang="FI" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI; mso-fareast-font-family: "Times New Roman";">Anief. Moh. 2000. <i>Farmasetika</i>. Yogyakarta :
Gajah Mada University Press.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span lang="PT-BR" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: PT-BR; mso-fareast-font-family: "Times New Roman";">Soetopo. Seno, dkk. 2001. <i>Teori Ilmu Resep</i>.
Jakarta.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"></span></li>
</ol>
</div>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-19808325925117485252013-01-18T18:23:00.001-08:002013-01-18T18:29:13.425-08:00THEME RED ALIENWARE<div dir="ltr" style="text-align: left;" trbidi="on">
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<br /></div>
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ini penampakan dekstopnya </div>
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<br /></div>
Langsung sedot aja tak perlu panjang lebar.<br />
cara pakainya gampang tidak usah ribet ribet seperti theme transparant lain<br />
1. download <a href="http://wahiddot.blogspot.com/2013/01/theme-red-alienware.html" target="_blank">THEMERED ALIENWARE </a><br />
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theme RED ALIENWARE for Windows7 64bit/32bit oke oke aja ukuran 18.2 mb<br />
<a href="http://www.4shared.com/file/lA-mixxb/Red_Alienware_Skin_Pack_20-X64.html" target="_blank"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0XDgS4MsV3-UYsnzQi_k-xMLuamwRHzxjK9ZmRvWIlU6PHsvwu5uA_mIcYhTmhfWGOQqxtaQW3nHQSOvsyOSOHeO03OWjz0H5m6nAIHIhr3W-BgS3mA1Q1bnsLVMcjhCC8Jkp9aLe9yQ/s200/download-button-fertig1.jpg" style="height: 66px; width: 152px;" /></a> <br />
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Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-18640060082001623292013-01-17T10:23:00.002-08:002013-01-18T18:40:41.218-08:00THEME FULL GLASS transparant<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEganoy94mUvmJqPXXcvr_1EzTanptQHEWqNHNPv1D7jyikscVqhcK4yzZTbjVMHYpw9cVJnYY54aiu37LqX5bdwP7OySMeACtg-K1hZS-fHUNy8ErmLjNdjpw1Ewi2R8ySFPFQpibbOD8k/s1600/111.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="225" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEganoy94mUvmJqPXXcvr_1EzTanptQHEWqNHNPv1D7jyikscVqhcK4yzZTbjVMHYpw9cVJnYY54aiu37LqX5bdwP7OySMeACtg-K1hZS-fHUNy8ErmLjNdjpw1Ewi2R8ySFPFQpibbOD8k/s400/111.png" width="400" /></a></div>
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</div>
Langsung sedot aja tak perlu panjang lebar.<br />
cara pakainya gampang tidak usah ribet ribet seperti theme transparant lain<br />
1. download <a href="http://www.4shared.com/rar/dtITWMF7/glassskinpack.html" target="_blank">THEME</a><br />
2. Extrak<br />
3. dan instal<br />
selesai <br />
theme GlassSkinpack for Windows7 64bit/32bit oke oke aja ukuran 18.2 mb<br />
<a href="http://www.4shared.com/rar/dtITWMF7/glassskinpack.html" target="_blank"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0XDgS4MsV3-UYsnzQi_k-xMLuamwRHzxjK9ZmRvWIlU6PHsvwu5uA_mIcYhTmhfWGOQqxtaQW3nHQSOvsyOSOHeO03OWjz0H5m6nAIHIhr3W-BgS3mA1Q1bnsLVMcjhCC8Jkp9aLe9yQ/s200/download-button-fertig1.jpg" style="height: 66px; width: 152px;" /></a> </div>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-64434376126183185322013-01-13T08:37:00.001-08:002013-01-17T10:59:48.573-08:00APPLIKASI UNLOCKER<div dir="ltr" style="text-align: left;" trbidi="on">
Applikasi buat menghapus file atau folder yang susah atau tidak bisa dihapus.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqLSmx1hSa9uvVznZxnOYuyZpc10_lvyTEP2M40zjClX_oZMusBYNHcBQ4xGSr1Onw0_pspy_CzqLtJQ6RzmBViMFSOSItNS2wpKFL6d4_Mv8-LsMbVe9OCMlYy6c1PSRVoq-wS_SoOpM/s1600/111.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="160" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqLSmx1hSa9uvVznZxnOYuyZpc10_lvyTEP2M40zjClX_oZMusBYNHcBQ4xGSr1Onw0_pspy_CzqLtJQ6RzmBViMFSOSItNS2wpKFL6d4_Mv8-LsMbVe9OCMlYy6c1PSRVoq-wS_SoOpM/s320/111.jpg" width="320" /></a></div>
download applikasinya, extrak dan install<br />
<br />
<br />
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<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTb3WKPlFFdsdS3OTZQEnafVkTf76hvvv7RLKVMm_2F2DKxoeW8iYOSpbaYGw20pqV8cJiTvPhYNJR9D3kQatP2Pop24_Qk7JdQCPZGjPGZsDI2fwieyctmSwGaEYMvilzgmPptC5jQgM/s1600/ggggg1.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="203" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTb3WKPlFFdsdS3OTZQEnafVkTf76hvvv7RLKVMm_2F2DKxoeW8iYOSpbaYGw20pqV8cJiTvPhYNJR9D3kQatP2Pop24_Qk7JdQCPZGjPGZsDI2fwieyctmSwGaEYMvilzgmPptC5jQgM/s320/ggggg1.jpg" width="320" /></a></div>
<br />
buka file atau folder yang mau dihapus. klik kanan, pilih unlocker.<br />
<br />
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<br />
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<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdi-5yZbysUkdEsu2aql8Tl3mQozJJRbcRCnThfgLliVMWM8CukK4A_m0gFm6fE4lfE6AxocKdTWMk11v86gK3q3pBOaAHVyOUxaEOiZnmTWVlRnUNERD-fhfj_CLHkuijDRLBzXLyGLg/s1600/222.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="176" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdi-5yZbysUkdEsu2aql8Tl3mQozJJRbcRCnThfgLliVMWM8CukK4A_m0gFm6fE4lfE6AxocKdTWMk11v86gK3q3pBOaAHVyOUxaEOiZnmTWVlRnUNERD-fhfj_CLHkuijDRLBzXLyGLg/s320/222.jpg" width="320" /></a></div>
pilihan No action pilih Delete. OK<br />
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Download <a href="http://www.4shared.com/rar/K_Mq8tso/AremaUnlocker_191.html" target="_blank"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0XDgS4MsV3-UYsnzQi_k-xMLuamwRHzxjK9ZmRvWIlU6PHsvwu5uA_mIcYhTmhfWGOQqxtaQW3nHQSOvsyOSOHeO03OWjz0H5m6nAIHIhr3W-BgS3mA1Q1bnsLVMcjhCC8Jkp9aLe9yQ/s200/download-button-fertig1.jpg" style="height: 66px; width: 152px;" /></a></div>
Anonymoushttp://www.blogger.com/profile/02964204413057332756noreply@blogger.com0tag:blogger.com,1999:blog-4031308222094698665.post-52628853968679498542013-01-06T17:01:00.002-08:002013-01-06T18:54:06.165-08:00Zat berbahaya dari rokok<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiOM7voNEzBNkcE4nuOaJKT8TSVYG_i2D_52TVE0EXHRa1GZzdHQxlMzuv4F5YbwfTDKAh6v2Cwp0o6xE8iDB-z0m2KeNikM4r7jwLSetSXT69OiOTHQ0iEmu4xl8hED1rRD4cXtqwzIpI/s320/r.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiOM7voNEzBNkcE4nuOaJKT8TSVYG_i2D_52TVE0EXHRa1GZzdHQxlMzuv4F5YbwfTDKAh6v2Cwp0o6xE8iDB-z0m2KeNikM4r7jwLSetSXT69OiOTHQ0iEmu4xl8hED1rRD4cXtqwzIpI/s320/r.jpg" /></a></div>
<div class="MsoNormal">
<span>Rokok<span> </span>salah satu benda yang membuat kocek
penggunanya menipis. Bagaimana tidak, perokok di Indonesia menghabiskan dana
lebih dari Rp 100 triliun/tahun hanya untuk membeli rokok. Salah satu cara
kemiskinan yang dibuat sendiri, tapi tidak sadar dengan perbuatanya. Bahkan
sebagian ada yang merasa berjasa ketika mereka menyukai rokok. </span>
</div>
<div class="MsoNormal">
<span>Selain menguras
kantong, rokok juga berbahaya bagi kesehatan penggunanya. Banyak zat-zat kimia
berbahaya terkandung di dalamnya yang masing-masing zatnya memiliki resiko yang
berbeda-beda. <strong>Mari kita lihat zat apa
saja yang terkandung di dalamnya :</strong></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.pantonanews.com/foto_berita/21danger-poison4.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="160" src="http://www.pantonanews.com/foto_berita/21danger-poison4.jpg" width="200" /></a></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span><strong><em> </em></strong></span>
</div>
<div class="MsoNormal">
<strong><em><span>Karbon Monoksida (CO) </span></em></strong>
</div>
<div class="MsoNormal">
<span>Gas CO adalah
sejenis gas yang tidak memiliki bau. Unsur ini dihasilkan oleh pembakaran yang
tidak sempurna dari unsur zat arang atau karbon. Gas ini dapat di hisap oleh
siapa saja. Oleh orang yang merokok atau orang yang terdekat dengan si perokok,
atau orang yang berada dalam satu ruangan. </span>
</div>
<div class="MsoNormal">
<span>Gas CO mempunyai
kemampuan mengikat hemoglobin (Hb) yang terdapat dalam sel darah merah
(eritrosit) lebih kuat dibanding oksigen, sehingga setiap ada asap rokok
disamping kadar oksigen udara yang sudah berkurang, ditambah lagi sel darah
merah akan semakin kekurangan oksigen, oleh karena yang diangkut adalah CO dan
bukan O2 (oksigen). </span>
</div>
<div class="MsoNormal">
<span>Sel tubuh yang
menderita kekurangan oksigen akan berusaha meningkatkan yaitu melalui
kompensasi pembuluh darah dengan jalan menciut atau spasme. Bila proses spasme
berlangsung lama dan terus menerus maka pembuluh darah akan mudah rusak dengan
terjadinya proses aterosklerosis (penyempitan). Penyempitan pembuluh darah akan
terjadi dimana-mana. Di otak, di jantung, di paru, di ginjal, di kaki, di
saluran peranakan, di ari-ari pada wanita hamil. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Nikotin </span></em></strong>
</div>
<div class="MsoNormal">
<span>Nikotin yang
terkandung di dalam asap rokok antara 0.5 – 3 ng, dan semuanya diserap,
sehingga di dalam cairan darah atau plasma antara 40 – 50 ng/ml. </span>
</div>
<div class="MsoNormal">
<span>Pada paru,
nikotin dapat menghambat aktivitas silia. Seperti halnya heroin dan kokain,
nikotin juga memiliki karakteristik efek adiktif dan psikoaktif. Perokok akan
merasakan kenikmatan, kecemasan berkurang, toleransi dan keterikatan fisik. Hal
itulah yang menyebabkan mengapa sekali merokok susah untuk berhenti. </span>
</div>
<div class="MsoNormal">
<span>Efek nikotin menyebabkan
perangsangan terhadap hormon kathekolamin (adrenalin) yang bersifat memacu
jantung dan tekanan darah. Jantung tidak diberikan kesempatan istirahat dan
tekanan darah akan semakin meninggi, berakibat timbulnya hipertensi. </span>
</div>
<div class="MsoNormal">
<span>Efek lain
merangsang berkelompoknya trombosit (sel pembekuan darah), trombosit akan
menggumpal dan akhirnya akan menyumbat pembuluh darah yang sudah sempit akibat
asap yang mengandung CO yang berasal dari rokok. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Tar </span></em></strong>
</div>
<div class="MsoNormal">
<span>Tar adalah
sejenis cairan kental berwarna coklat tua atau hitam yang merupakan substansi
hidrokarbon yang bersifat lengket dan menempel pada paru-paru. Kadar tar pada
rokok antara 0,5-35 mg per batang. Tar merupakan suatu zat karsinogen yang
dapat menimbulkan kanker pada jalan nafas dan paru-paru. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Cadmium </span></em></strong>
</div>
<div class="MsoNormal">
<span>Cadmium adalah
zat yang dapat meracuni jaringan tubuh terutama ginjal. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Akrolein </span></em></strong>
</div>
<div class="MsoNormal">
<span>Akrolein
merupakan zat cair yang tidak berwarna dan agak banyak mengandung kadar
alcohol. Artinya, akrolein ini adalah alcohol yang cairannya telah diambil.
Cairan ini sangat mengganggu kesehatan. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Amoniak </span></em></strong>
</div>
<div class="MsoNormal">
<span>Amoniak
merupakan gas yang tidak berwarna yang terdiri dari nitrogen dan hydrogen. Zat
ini tajam baunya dan sangat merangsang. Begitu kerasnya racun yang ada pada
amoniak sehingga memgakibatkan seseorang pingsan atau koma jika masuk ke dalam
peredaran darah. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Asam Format </span></em></strong>
</div>
<div class="MsoNormal">
<span>Asam format
merupakan sejenis cairan tidak berwarna yang bergerak bebas. Cairan ini sangat
tajam dan menusuk baunya. Zat ini dapat menyebabkan seseorang seperti merasa
digigit semut. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Hidrogen Sianida (HCN) </span></em></strong>
</div>
<div class="MsoNormal">
<span>HCN merupakan
sejenis gas yang tidak berwarna, tidak berbau dan tidak memiliki rasa. Zat ini
merupakan gas yang paling ringan, mudah terbakar, dan sangat efisien untuk
menghalangi pernapasan dan merusak saluran pernapasan. Sianida adalah salah
satu zat yang mengandung racun yang sangat berbahaya. Bahkan, jika hanya
sedikit sianida yang dimasukkan ke dalam tubuh dapat mengakibatkan kematian. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Nitrous Oxid </span></em></strong>
</div>
<div class="MsoNormal">
<span>Nitrous oxide
merupakan sejenis gas yang tidak berwarna, dan bila terhisap dapat menyebabkan
hilangnya pertimbangan dan menyebabkan rasa sakit. Nitrous oxide ini adalah
sejenis zat yang pada mulanya dapat digunakan sebagai pembius waktu melakukan
operasi oleh dokter. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Formaldehid </span></em></strong>
</div>
<div class="MsoNormal">
<span>Formaldehid
adalah sejenis gas tidak berwarna dengan bau tajam. Gas ini tergolong sebagai
pengawet dan pembasmi hama. Gas ini juga sangat beracun keras terhadap semua
organism hidup. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Fenol </span></em></strong>
</div>
<div class="MsoNormal">
<span>Fenol adalah
campuran dari kristal yang dihasilkan dari distilasi beberapa zat organic
seperti kayu dan arang, serta diperoleh dari tar arang. Zat ini beracun dan membahayakan
karena fenol ini terikat ke protein dan menghalangi aktivitas enzim. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Asetol </span></em></strong>
</div>
<div class="MsoNormal">
<span>Asetol adalah
hasil pemanasan aldehid (sejenis zat yang tidak berwarna yang bebas bergerak)
dan mudah menguap dengan alcohol. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Hidrogen sulfida </span></em></strong>
</div>
<div class="MsoNormal">
<span>Hidrogen sulfida
adalah sejenis gas yang beracun yang gampang terbakar dengan bau yang keras.
Zat ini menghalangi oksidasi enzim (zat besi yang berisi pigmen). </span>
</div>
<div class="MsoNormal">
<strong><em><span>Piridin </span></em></strong>
</div>
<div class="MsoNormal">
<span>Piridin adalah
sejenis cairan tidak berwarna dengan bau tajam. Zat ini dapat digunakan
mengubah sifat alcohol sebagai pelarut dan pembunuh hama. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Metil Klorida </span></em></strong>
</div>
<div class="MsoNormal">
<span>Metil klorida
adalah campuran dari zat-zat bervalensi satu antara hydrogen dan karbon merupakan
unsurnya yang utama. Zat ini adalah senyawa organic yang beracun. </span>
</div>
<div class="MsoNormal">
<strong><em><span>Metanol </span></em></strong>
</div>
<div class="MsoNormal">
<span>Metanol adalah
sejenis cairan ringan yang mudah menguap dan mudah terbakar. Meminum atau
menghisap methanol mengakibatkan kebutaan dan bahkan kematian. </span>
</div>
<div class="MsoNormal">
<span>Mekipun banyak
yang sudah tau bahwa merokok dapat merugikan kesehatan namun masih sangat
sedikit yang peduli dengan bahaya merokok, itu terbukti dengan masih banyaknya
dan bertambahnya orang yang merokok. Setiap orang yang merokok biasanya akan
menjadi ketagihan dan sangat sulit untuk tidak merokok. Banyaknya dan
bertambahnya perokok itu awalnya hanya iseng, cobo-coba lalu
ketagihan/kecanduan dan terus menjadi perokok aktif. (Lutfia Nur Izzati)</span>
</div>
<div class="MsoNormal">
<strong><span>Sumber :</span></strong>
</div>
<div class="MsoNormal">
<span>http://naturalcrystalx-wanitacantik.blogspot.com/2012/06/bahan-kimia-terkandung-dalam-rokok.html
</span>
</div>
<div class="MsoNormal">
<span>http://teyhirafarm.wordpress.com/2009/02/02/kandungan-kimia-rokok-dan-bahayanya/
</span>
</div>
<div class="MsoNormal">
<span>http://www.psychologymania.com/2012/02/zat-kandungan-dalam-rokok.html
</span>
</div>
<div class="MsoNormal">
<span>http://nadhienove.blogspot.com/2012/01/bahaya-rokok-kandungan-bahan-kimia.html</span>
</div>
<div class="MsoNormal">
<span>Sumber Gambar:<br />
</span>
</div>
<span>http://geantvert.canalblog.com/</span></div>
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