The First Line Maintenance Fluid Therapy

for Hospitalized Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution
for Better Clinical Outcome
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

Kondisi pasien di ruang perawatan

● Kebanyakan sudah berada dalam dehidrasi
moderat, namun hemodinamik tidak terlalu buruk
● Cemas, depresi atau takut
● Lesu atau letih
● Tidak terbiasa dengan makanan rumah sakit
● Asupan oral kurang (terlalu lemah untuk
mengunyah atau lidah pahit karena kering)
● Jam makan yang tidak fleksibel
● Anoreksia, mual, atau nyeri
● Kesadaran menurun
Memerlukan Dukungan Terapi Cairan Maintenance
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

Sasaran Terapi Cairan Maintenance

● Memenuhi kebutuhan fisiologis harian untuk
homeostasis
● Mencegah gangguan elektrolit dan asam-basa
● Mendukung terapi primer untuk penyakit pasien
● Proses enzimatik & sintesis protein
● Memfasilitasi penyembuhan
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

Kebutuhan harian elektrolit & cairan ( Dewasa sehat )

Composition of Aminofluid compared with Ringer’s Lactate & KA-EN 3B

Composition AMINOFLUID® KA-EN 3B® Ringer’s lactate ASPEN guideline *

Water 2000 2000 2000 30-40 ml/kg/day
Na + 70 100 260 1-2 mEq/kg/day
K+ 40 40 8 1-2 mEq/kg*/day
-
Cl 70 100 218 as needed
Mg ++ 10 - - 8-20 mEq/day
Ca ++ 10 - - 10-15 mEq/day
P 20 - - 20-40 mEq/day
Zn 10 µmol - - 2.5-5 gr
Amino acid AA 60 g - - 0.8 g/kg/day 
Glucose 150 g ¥ 54 g -
* basic requirement for K+ homeostasis 20-30 mEq/daily (10) ;
 basal amino acid requirement in nonstressed patients; ¥ protein-sparing effect

Ref. : ASPEN Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral
nutrition in adult and pediatric patients. JPEN Vol 26, No1 Suppl Jan-Feb 2002.
 The First Line Maintenance Fluid Therapy for Hospitalized Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

AMINOFLUID® :
● Dikemas dalam advanced double chamber soft bag,
mudah dan praktis serta aman pemakaiannya
● Bukan hanya mengandung :
- Elektrolit dasar ( Na+, K+, Cl- ) tetapi juga mengandung mikromineral
( Mg++, Ca++, P ) yang diperlukan untuk metabolisme seluler
- Trace element Zinc untuk mendukung penyembuhan jaringan dan
imunitas seluler
● Bahkan lebih dari itu juga mengandung :
- Asam Amino kualitas tinggi ( BCAA dan EAA kadar tinggi ) untuk
mendukung sintesis protein, dan
- Glukosa untuk mempertahankan kadar gula darah secara optimal
(euglycemia)
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

Peran dan manfaat BCAA ( Leucine, Isoleucine & Valine ) :

● Prekursor penting dalam sintesis glutamin dan
alanin di otot rangka
● Leucine memacu sintesis protein

● BCAA meningkatkan napsu makan

(Kebutuhan harian BCAA : 144 mg/Kg/hari *)

* Roya Riazi all . The total BCAA Req. in young healthy adult men determined by indicator AA Oxid Phenylalanine. J.Nutr. 133 : 1383 – 1389 May 2003
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

Mekanisme timbulnya Anoreksia

Diseases
Neuron Anorexia

NPY
AgRP
POMC + Cytokines
5-HT
(TNF,IL-1,IL-6)

Tryp

BCAA

Pada banyak penyakit sistemik, sitokin akan diproduksi oleh sel darah putih, dan ini akan merangsang
pembentukan serotonin dan merangsang melanocortin. Efek perangsangan ini adalah anoreksia. Serotonin
berasal dari triptofan. Triptofan masuk dalam sistem saraf pusat melalui saluran yang sama dengan BCAA.
Jadi trIptofan bersaing dengan BCAA. Ada bukti bahwa peningkatan triptofan di otak akan menyebabkan rasa
letih (central fatigue).
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

BCAA meningkatkan nafsu makan

Diseases
Neuron Appetite

NPY
AgRP POMC + Cytokines
5-HT (TNF,IL-1,IL-6)

Tryp

BCAA
Pemberian BCAA (leucine, isoleucine, valine), akan memblok masuknya triptofan, disusul
dengan penurunan serotonin. Kemudian nafsu makan akan meningkat
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

Peran Zinc dan Jumlah ekskresi Zinc melalui urin

● Berfungsi sebagai co-factor Zinc

dalam metabolisme > 70 macam enzim ∑ Eksresi Urine Kandungan pada
harian pada orang AMINOFLUID®
● Berperan dalam metabolisme sehat *
nutrien (karbohidrat, protein,
dan lemak) Rata2. 500 µg 660 µg
( 7.6 µmol) (10 µmol)
● Berperan dalam pembelahan sel
dan mempertahankan membran sel Zinc pada Aminofluid sebagai suplemen
untuk menggantikan kehilangan karena
● Berperan dalam penyembuhan ekskresi urin.
jaringan dan Imunitas Seluler. * Arakawa Y, et al. In: Trace elements and gastrointestinal
diseases. Tokyo: Shinko Igaku Shuppan; 1990. p119
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

Komposisi AMINOFLUID®500 ML
Ingredients Composition Ingredients Composition
L-Isoleucine 1.2 Sodium 17.5
L-Leucine 2.1 Potassium 10
L-Lysine 1.57 Magnesium 2.5
Essential amino acid L-Methionine 0.58 Calcium 2.5
(g/500 mL) L-Phenylalanine 1.05 Chloride 17.5
L-Threonine 0.85 Electrolytes Sulfate 2.5
L-Tryptophan 0.3 (mEq/L) Acetate 6.5
L-Valine 1.2 Gluconate 2.5
L-Alanine 1.2 Lactate 10
L-Arginine 1.57 Citrate 3
L-Histidine 0.75 Phosphorus (mmol/L) 5
L-Proline 0.750 Zinc (µmol/L) 2.5
Nonessential amino acid L-Serine 0.45 Total amino acids 15 gr
(g/500 mL) L-Tyrosine 0.075 BCAA (% in Total amino acids) 4.5 gr
Glycine 0.885 Dextrose 37.5 gr
L-Cysteine 0.150 Total energy in 500 mL 210 kcal
L-Glutamic acid 0.150 Osmolarity (mOsm/Lt) ± 817
L-Aspartic acid 0.150 pH ~6.7
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

Komposisi AMINOFLUID®1000 ML
Ingredients Composition Ingredients Composition
L-Isoleucine 2.4 Sodium 35
L-Leucine 4.2 Potassium 20
L-Lysine 3.15 Magnesium 5
Essential amino acid L-Methionine 1.17 Calcium 5
(g/1000 mL) L-Phenylalanine 2.1 Chloride 35
L-Threonine 1.71 Electrolytes Sulfate 5
L-Tryptophan 0.6 (mEq/L) Acetate 13
L-Valine 2.4 Gluconate 5
L-Alanine 2.4 Lactate 20
L-Arginine 3.15 Citrate 6
L-Histidine 1.5 Phosphorus (mmol/L) 10
L-Proline 1.5 Zinc (µmol/L) 5
Nonessential amino acid L-Serine 0.9 Total amino acids 30 gr
(g/1000 mL) L-Tyrosine 1.5 BCAA (% in Total amino acids) 9 gr
Glycine 1.77 Dextrose 75 gr
L-Cysteine 0.3 Total energy in 1,000 mL 420 kcal
L-Glutamic acid 0.3 Osmolarity (mOsm/Lt) ± 817
L-Aspartic acid 0.3 pH ~6.7
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

CLINICAL EXPERIENCE
AMINOFLUID®
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

Data Penelitian T hyp o id Fe ve r

3
5 Diab e te s Me llitus

5 20

Gastritis/Dysp e p sia

De ng ue H Fe ve r

11

C irrho sis He p atis

* n = 58 14

Bro nko p ne umo nia

* Distribution of Patients by Diagnosis

Ref.: Yakobus Albert Presented during IDDW International Digestive Diseases Week Borobudur Hotel, April, 4 2008
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

FORM PATIENT REPORTED OUTCOME

Metode Penelitian INISIAL PASIEN:____________

MASUK TGL:___________

SKOR FATIGUE
Diagnosis
______________

PILIH
Aminofluid diberikan
tgl

SKOR
tgl

SKOR
tgl

SKOR
(bag)
tgl

SKOR
tgl

SKOR
Tgl
1 MERASA BERTENAGA Tidak pernah 5
Sedikit waktu 4
Kadang-kadang 3

MONITORING :
Kebanyakan 2
Selalu 1

2 MERASA LETIH/LELAH Tidak pernah 1

in first day and 5th day Sedikit waktu

Kadang-kadang
Kebanyakan
2
3
4
Selalu 5

3 BANGUN PAGI MERASA Sangat 1

Blood glucose, Creatinine, Albumin, SEGAR Segar

Cukup Segar
Kurang segar
2
3
4

Natrium, Potasium, 4 LETIH/LELAH MERUPAKAN

Tidak sama sekali

Tidak pernah
5

1
SALAH SATU DARI 3 KELUHAN Sedikit waktu 2

SGOT/AST, SGPT/ALT, YANG PALING MENYIKSA Kadang-kadang

Kebanyakan
Selalu
3
4
5

Scores of appetite, Fatique and ADL*), TOTAL SCORE

APPETITE

risk of thrombophlebitis TIDAK NAPSU MAKAN/MINUM

SAMA SEKALI
5

HANYA BISA MINUM 4

BISA MINUM & MAKAN SEDIKIT 3

*)ADL : Activities of Daily Living Score MAKAN DAN MINUM CUKUP 2

MAKAN BANYAK 1

NAMA DOKTER :___________________________

TANDA TANGAN:____________________________

Ref.: Yakobus Albert Presented during IDDW International Digestive Diseases Week
Borobudur Hotel, April, 4 2008
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

Hasil Penelitian
Monitoring Day 1 Day 5
Blood glucose (mg/dL) 128.05  10.81 130.62  9.51 Parenteral
Creatinine ( mg/dL) 0.92  0.09 0.89  0.04 Nutrition
Albumin (mg/dL) 3.89  0.92 3.82  0.90 (others)
SGOT/AST (IU/dL) 30.08  6.82 34.09  7.88
SGPT/ALT (IU/dL) 32.36  4.86 30.09  4.57
Potasium (mmol/dL) 3.44  1.09 3.72  1.02
Natrium (mmol/dL) 138.07  12.09 137.01  10.06
Fatigue score 14.34 8.16
Appetite score 3.48 2.06
ADL score 2.13 - 3.34
Thrombophlebitis
(observed at 3th days) 6.97% 47%
HJA( Rp/ml) 195/ml 250 - 650/ml
Ref.: Yakobus Albert Presented during IDDW International Digestive Diseases Week Borobudur Hotel, April, 4 2008
 The First Line Maintenance Fluid Therapy for Hospitalized
Patients

AMINOFLUID®
Electrolytes, 7.5% Glucose, 3% Amino Acids
Practical and Complete Maintenance Solution for Better Clinical Outcome

KESIMPULAN
Pemberian AMINOFLUID® pada pasien-pasien Thypoid,
Gastritis, DHF yang di rawat di RS dapat meningkatkan :
- Appetite Score
- Fatigue Score
- ADL (Activity Daily Living) Score
Sehingga pasien lebih cepat segar dan membantu mempercepat
penyembuhan.