Implementation of Standardized Nutrition Care Process in Severe Pediatric Respiratory Cases

Authors

  • Gusti Ayu Nyoman Hariani Poltekkes Kemenkes Denpasar, Indonesia
  • Ni Nyoman Sariasih Prof. Dr. I.G.N.G. Ngoerah Central General Hospital, , Indonesia
  • Adriyani Adam Poltekkes Kemenkes Makassar, Indonesia
  • Nursalim Poltekkes Kemenkes Makassar, Indonesia

Keywords:

Nutrition Care, PICU, ARDS, Pneumonia, Enteral Nutrition, Amino Acids.

Abstract

A 1-year-and-9-month-old male patient was admitted to the Pediatric Intensive Care Unit at Prof. Dr. I.G.N.G. Ngoerah General Hospital with a complex multiorgan condition, including severe acute respiratory distress syndrome, recurrent pneumonia, spasmodic croup, secundum atrial septal defect, and epilepsy. This condition led to high metabolic stress, feeding difficulties, and mild protein-energy malnutrition. This study aimed to provide standardized nutritional care to support metabolic stability, meet increased energy needs, and prevent further nutritional deterioration. A case study was conducted using the Standardized Nutrition Care Process from March 10–17, 2026. Enteral nutrition was administered via nasogastric tube using an amino acid-based formula (Neocate Junior) with a step-up approach to prevent refeeding syndrome, starting from 552.3 kcal and progressing toward 990 kcal. The intervention showed positive outcomes. The patient’s consciousness improved on the first day, and by day 6, energy intake reached 100% of the target, increasing to 80.8% by day 7. Hemoglobin levels improved from 8.7 g/dL to 10.9 g/dL, while body weight remained stable at 9 kg. Gradual enteral nutrition proved effective in supporting recovery and preventing catabolism in critically ill pediatric patients.

References

1. Bos LDJ, Ware LB. Series Acute Respiratory Distress Syndrome 2022 1 Acute respiratory distress syndrome : causes , pathophysiology , and phenotypes. Lancet [Internet]. 2022;400(10358):1145–56. Tersedia pada: http://dx.doi.org/10.1016/S0140-6736(22)01485-4

2. Sdravou K, Emmanouilidou-fotoulaki E, Printza A, Andreoulakis E, Beropouli S, Makris G, et al. Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases. 2021;1–14.

3. Mehta NM, Skillman HE, Irving SY, Coss-bu JA, Vermilyea S, Farrington EA, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient : Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. 2017.

4. WHO. EPILEPSY A Public Health Imperative. 2019.

5. Survei Kesehatan Indonesia. Dalam angka. 2023;

6. Ju J, Wong M, Tan HL, Sultana R, Ma Y, Aguilan AB, et al. Respiratory Support After Extubation in Children With Pediatric ARDS. 2024;422–9.

7. Vazzana GF, Romano A. Nutritional Issues in Children with Congenital Heart Diseases ( CHDs ). 2025;1–18.

8. Al-beltagi M, Saeed NK, Bediwy AS, Elbeltagi R. Unraveling the nutritional challenges in epilepsy : Risks , deficiencies , and management strategies : A systematic review. 2025;15(2):1–47.

9. Access O. 75th Congress of the Italian Society of Pediatrics. 2019;45(Suppl 3):119–32.

10. Sari P, Gz S, Kes MH, Gz S, Si M, Sari D, et al. DIETETIKA. 2025.

11. Becker P, Carney LN, Corkins MR, Monczka J, Smith E, Smith SE, et al. Consensus Statement of the Academy of Nutrition and Dietetics / American Society for Parenteral and Enteral Nutrition : Indicators Recommended for the Identification and Documentation of Pediatric Malnutrition ( Undernutrition ) Definition of Pediatric Malnutrition Acute vs Chronic Undernutrition. 2015;

12. Apriyanto, Wanda D, Lestari AW. STRONGKIDS dan STAMP Sebagai Alat Skrining Gizi yang Sensitif dalam Mendeteksi Risiko Malnutrisi pada Anak Apriyanto. J Penelit Kesehat Suara Forikes. 2024;15(8):791–7.

13. Tommy T, Dimiati H, Abdullah MN, Yusuf S, Thaib TM, Andid R, et al. Paediatrica Indonesiana. Paediatr Indones. 2022;62(3):192–7.

14. Katsagoni CN, Cheirakaki O, Hatzoglou A, Zerva O, Koulieri A, Loizou K, et al. Malnutrition in Hospitalised Children — An Evaluation of the Efficacy of Two Nutritional Screening Tools. Nutrients. 2021;13:1–11.

15. Statistics WH. World Health Statistics. World Health Organization. 2019. 1–13 hal.

16. Board N, Academies N. Dietary Reference Intakes ( DRIs ): Recommended Dietary Allowances and Adequate Intakes , Vitamins *.

17. Yuwono SR, Taher A, Minarto, Sugeng Eko Irian. Pedoman Pelayanan Gizi Rumah Sakit. Alisyahbana, Mulyono H, Rusriyanto, editor. Jakarta; 2013. 7823–7830 hal.

18. Singer P, Reintam A, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN Guideline ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr [Internet]. 2019;38(1):48–79. Tersedia pada: https://doi.org/10.1016/j.clnu.2018.08.037

19. Article R. Resting energy expenditure in critically ill patients : Evaluation methods and clinical applications. 2016;62(7):672–9.

20. Onis M De, Branca F. Review Article Childhood stunting : a global perspective. 2016;12:12–26.

21. Molina M, Segarra O, Diaz-martin JJ. in pediatric patients with allergy of experts. Front Pediatr Abbreviations. 2023;(March):1–13.

22. Khandaker MU, Almalki M, Wilairatana P, Mubarak MS. Exploring the Immune-Boosting Functions of Vitamins and Minerals as Nutritional Food Bioactive Compounds : A Comprehensive Review. 2022;

23. Ning S, Zeller MP. Management of iron de fi ciency. 2019;315–22.

24. Almatsier S. Prinsip dasar ilmu gizi [Internet]. Gramedia Pustaka Utama; 2002. Tersedia pada: https://books.google.co.id/books?id=aEmYNwAACAAJ

25. Nutrition Care Process Terminology (NCPT). 2017;

Downloads

Published

2026-05-30

How to Cite

Nyoman Hariani, G. A., Sariasih, N. N., Adam, A., & Nursalim. (2026). Implementation of Standardized Nutrition Care Process in Severe Pediatric Respiratory Cases. Jurnal Ilmu Gizi : Journal of Nutrition Science, 15(2), 140–150. Retrieved from https://ejournal.poltekkes-denpasar.ac.id/index.php/JIG/article/view/5141

Issue

Vol. 15 No. 2 (2026): Jurnal Ilmu Gizi : Journal of Nutrition Science

Section

Research Article

Citation Check

License

Copyright (c) 2026 Gusti Ayu Nyoman Hariani, Ni Nyoman Sariasih, Adriyani Adam, Nursalim

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

  1. Penulis menyimpan hak cipta dan memberikan jurnal hak penerbitan pertama naskah secara simultan dengan lisensi di bawah Creative Commons Attribution License yang mengizinkan orang lain untuk berbagi pekerjaan dengan sebuah pernyataan kepenulisan pekerjaan dan penerbitan awal di jurnal ini.
  2. Penulis bisa memasukkan ke dalam penyusunan kontraktual tambahan terpisah untuk distribusi non ekslusif versi kaya terbitan jurnal (contoh: mempostingnya ke repositori institusional atau menerbitkannya dalam sebuah buku), dengan pengakuan penerbitan awalnya di jurnal ini.
  3. Penulis diizinkan dan didorong untuk memposting karya mereka online (contoh: di repositori institusional atau di website mereka) sebelum dan selama proses penyerahan, karena dapat mengarahkan ke pertukaran produktif, seperti halnya sitiran yang lebih awal dan lebih hebat dari karya yang diterbitkan. (Lihat Efek Akses Terbuka).