AI

NUTRISI ANAK SAKIT KRITIS

Divisi PGD FK UNDIP / RSDK Semarang

1

Select route of Nutrition: Enteral or parenteralIs patient able to

meet nutrition

goals orally?

Yes

No

Exit algorithm

Is patient able to meet

nutrition goals enterally?

Yes

No

Consider parenteral nutrition

Is patient ready to advance to full

enteral nutrition?

Yes

No

Does patient have risk factors for aspiration?

Consider trophic feeds 0,5

ml/kg/hr (max 20 ml/hr)

Reassess daily

Yes

No

Start gastric feed

1 ml/kg/hr (max 25

ml/hr)Start post-

pyloric feed1 ml/kg/hr (max 25 ml/hr)

After 4 hrs:Measure GRV and assess for signs of

intolerance

Does patient have GRV > 3 ml/kg or evidence of EN intolerance?

Yes

No

Hold rate for 1 hrReplace GRV

Advance feedMeasure GRV and assess

signs of intolerance (q 4 hrs)Reassess after 1 hr

for sign of intolerance

Does patient still have GRV > 3

ml/kg or evidence of EN intolerance?

Yes

No

Stop feed for 4 hrsModifikasi ASPEN 2010

AI

2

Pedoman pemberian nutrisi enteral di PICU