DOI: https://doi.org/10.14710/jai.v0i0.67337

NUTRITION THERAPY IN POST-HARTMANN PROCEDURE PATIENTS IN THE INTENSIVE CARE UNIT

Department of Anesthesia and Intensive Therapy, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University, Special Region of Yogyakarta, Indonesia, Indonesia

Received: 8 Oct 2024; Revised: 7 Jan 2025; Accepted: 11 Mar 2025; Published: .
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

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Abstract

Background: The Hartmann procedure is a surgical procedure for treating colorectal cancer that is widely used in emergencies because it is fast and has a minimal risk of anastomotic leakage. This procedure is usually performed on rectosigmoid cancer. Colorectal cancer patients who undergo gastrointestinal surgery are considered at risk of malnutrition, so adequate nutritional therapy is needed.

Patient: We report a 51-year-old male patient who came to the intensive care unit (ICU) with an unconscious condition, was intubated, received norepinephrine support, and had a reddish black NGT. The patient was referred with a diagnosis of postoperative Hartmann procedure H-3 for indications of high obstructive ileus ec rectosigmoid tumor, septic shock, acute kidney injury (AKI), and stress ulcers. During treatment in the ICU, the patient received the antibiotic therapy meropenem and metronidazole, proton pump inhibitors (PPIs), and parenteral nutrition via a central venous catheter (CVC).

Discussion: In this patient, parenteral nutrition was given from the beginning of admission to the ICU because oral nutrition and enteral nutrition could not be given. Parenteral nutrition was given from the beginning because the patient was considered at risk of malnutrition with evidence of critical illness for > 48 hours, postgastrointestinal surgery patients due to cancer, there was a postoperative fasting period, and enteral nutrition could not be given because there was gastrointestinal bleeding (stress ulcer).

Conclusion: Nutritional therapy, as part of the management of critically ill patients, should be given at the right time, in the most effective way, and in doses appropriate for individuals to avoid malnutrition during treatment.

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Keywords: Acute kidney injury; Hartmann procedure; Parenteral nutrition; Septic shock; Stress ulcer.

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Section: Case Reports
Language : EN
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