MACRO AND MICRONUTRIENT

SUPPORTING TREATMENT IN SEPSIS

A. Guntur H.
* Sub. Bagian Penyakit Tropik Infeksi-Imunologi Bagian Ilmu Penyakit Dalam
RSUD.Dr. Moewardi / FK. UNS. Surakarta

Infection disease and critical illness ( CI ) patients which is caring in the hospital
could easily fall into malnutrition that caused by inadequate nutrient intake. Malnutrition
causes prolonged treatment, healing process, mortality and morbidity. There are any
changes in Critical illness i.e ; metabolism rate increase 10%-29% , energy expenditure
50%, increasing glucose production by glicogenolysis and gluconeogenesis lead to insulin
intolerance and also lipid metabolism. Skeletal muscle proteolysis associate to ; body
weight loss, immune response alteration. Alteration of amino acid profile could be found
in CI which characterized by decreasing plasma glutamine and branch chain amino acid
level.
Micronutrient status is important factor contributing to immune competence. It is
essential that an activated immune system receives adequate nutrition for proper function.
Micronutrients are required to help the immune system meet the increased demand
building blocks and energy during process such as regulation of biosynthesis (i.e folate,
iron, zinc, magnesium), cell signalling (calcium, sodium, potassium) and protection againts
damage (i.e copper, zinc, selenium, antioxidants such as vitamins C and E). Micronutrients
that have been demonstrated in human and animal studies to be essential for an optimal
immune response include essential amino acids, linoleic acid, vitamin A, vitamin B6, folic
acid, vitamin B12, vitamin C, Vitamin E, zinc, copper, iron and selenium.

Keywords : Critical Illness, Macro-micronutrient