RANGKUMAN JURNAL-

JURNAL NUTRISI DAN

FEEDING PADA ANAK
DENGAN PENYAKIT
JANTUNG BAWAAN (PJB)
Tabel Rangkuman Jurnal
Peneliti Judul Populasi Desain Modalita Hasil
Penelitia dan Penelitia s/
n Sampel n Intervens
i
Sjarif et Anthropo Populasi: Cross- Pengukur Prevalensi
al. (2011) metric Anak sectional an kekurang
Profiles berusia 0- antropom an gizi
of 2 tahun etri (BB, 51,1%
Children dengan PB, LK); dengan
with PJB di Z-score 22,3% gizi
Congenit RSCM. BB/PB, buruk.
al Heart Sampel: BB/U, FTT
Disease 95 subjek PB/U, 64,9%,
(73 LK/U <-2 perawaka
asianotik SD; n pendek
dan 22 Konsultasi 49,5%,
sianotik) diet untuk mikrosef
malnutrisi ali 37%.
FTT lebih
tinggi
pada lesi
asianotik
(72,2%) vs
sianotik
(42,9%).
Pada
asianotik,
BB lebih
terganggu
daripada
PB (72,2%
vs 49,3%).
Davis et Feeding Populasi: Retrospec Evaluasi HLHS vs
al. (2008) Difficulti Neonatus tive chart feeding d-TGA:
es and dengan review difficulties BB di 1
Growth HLHS dan dan bulan
Delay in d-TGA. growth (3,29±0,5
Children Sampel: assessme 8 vs
with 27 dengan nt di 1, 6, 3,70±0,60
HLHS HLHS dan 12 bulan kg,
versus d- 26 dengan post-natal p=0,021);
TGA d-TGA 6 bulan
(6,27±1,0
6 vs
7,31±1,02
kg,
p=0,003);
12 bulan
(8,40±1,1
1 vs
9,49±1,01
kg,
p=0,006).
Waktu
mencapa
i full
caloric
intake
(100
kcal/kg/d
ay):
HLHS
24±11,9
hari vs d-
TGA
12,0±11,
2 hari
(p<0,001
).
Komplikas
i feeding:
HLHS
48% vs d-
TGA 4%
(p=0,001)
.
Hehir et Feeding, Populasi: Prospectiv Home 55%
al. (2011) Growth, Neonatus e monitorin pasien
Nutrition dan bayi observatio g (89 dari
, and dengan nal program: 145)
Optimal HLHS program saturasi mengala
Interstag pasca O2 mi
e Norwood harian, pelangga
Surveilla Stage 1. BB, ran
nce for Sampel: volume protokol:
Infants 145 asupan 46 dari 89
with pasien enteral; terkait
HLHS dengan Interstage feeding/gr
monitorin surveillan owth.
g ce Intervens
interstage guidelines i:
; peningkat
Nutritiona an
l volume/ka
interventi lori
on formula,
admission
untuk
penuruna
n
BB/dehidr
asi,
penempat
an
NGT/GTT.
Feeding/g
rowth
adalah
indikasi
terbanyak
intervensi
nutritional
.
Interstage
mortality
dapat
dikurangi
dari 15-
22%
menjadi 0-
10%
dengan
program
monitorin
g ketat.
Kołodziej A Populasi: Systemati Literature Hanya 2
& Systemat Review c review review guidelines
Skulimow ic Review sistematis dengan dan yang
ska (2024) of dari 765 AGREE II assessme memenuhi
Clinical publikasi tool nt kualitas kriteria
Practice hingga assessme guidelines inklusi.
Guidelin Septembe nt mengguna Skor
es on the r 2023. kan AGREE II
Manage Sampel AGREE II keseluru
ment of final: 2 instrumen han 75%
Malnutri guidelines t (Mills et
tion in yang al. 2022:
Children memenuhi 83%;
with kriteria Slicker
CHD (2013 dan et al.
2022) 2013:
67%).
Domain
terlemah
adalah
applicabili
ty (21%).
Rekomen
dasi
konsiste
n antara
kedua
guideline
s: energi
requireme
nts,
nutrient
requireme
nts,
enteral
nutrition,
feeding
practices,
parenteral
nutrition.
Kesimpul
an: ada
kebutuha
n
guidelines
yang lebih
komprehe
nsif
dengan
strategi
implemen
tasi yang
jelas.
Norman Prevalen Populasi: Scoping Sintesis Overall
et al. ce of Review review literature pooled
(2022) Feeding scopting (15 artikel tentang prevalen
and dari 1.107 seleksi prevalensi ce FSD:
Swallowi partisipan dari 1.448 feeding 42,9%.
ng di 15 awal) and Prevalensi
Disorder artikel swallowin aspirasi:
s in CHD: peer- g 32,9%.
A reviewed. difficulties Prevalen
Scoping Age (FSD) si
Review range: bervarias
neonatus i (range
prematur luas)
hingga 17 tergantun
tahun. g: age,
definisi
FSD,
assessme
nt tools
yang
digunakan
. Faktor
penyebab
: difficulty
breathing-
swallowin
g
coordinati
on,
fatigue,
GERD,
aspiration
risk.
Kesimpul
an: FSD
common
pada
CHD,
assessme
nt dan
managem
ent harus
menjadi
bagian
standard
care.
Chen et Growth Populasi: Cross- Pengukur Growth:
al. (2004) and Preschool sectional an height, Signifikan
Develop children descriptiv weight, lebih
ment of 3-6 tahun. e growth rendah
Children Sampel: curve pada CHD
with 42 dengan assessme vs normal
Congenit CHD dan nt; (p<0,05
al Heart 116 Denver untuk BB
Disease normal Developm dan
ental tinggi).
Screening Lebih
Test II banyak
untuk CHD di
developm bawah
ental persentil
assessme 50 untuk
nt tinggi
(p<0,05)
dan BB
(p<0,001)
.
Develop
ment:
CHD lebih
suspicious
dalam
language
(p<0,01)
dan gross
motor
(p<0,001)
. FTT dan
developm
ental
delay
lebih
prevalent
pada CHD
group.
Smith Undernu Populasi: Prospectiv Z-scores Baseline:
Robyn et trition in Anak ≤30 e untuk 27 pasien
al. (2024) Young bulan observatio weight- (67,5%)
Children dengan nal height, underwei
with CHD di descriptiv head ght, 18
CHD central e circumfer (45%)
Undergoi South ence-for- stunted.
ng Africa. age; 25%
Cardiac Sampel: Bayley-III dengan
Surgery 40 untuk feeding
in Low- mother- motor difficulti
Income child pairs developm es. Post-
Environ (28 ent; operasi
ment menjalani Parenting (6
(South cardiac stress bulan):
Africa) surgery) assessme Signifikan
nt improvem
ent pada
BB
(p=0,04)
dan head
circumfer
ence
(p=0,02),
tapi catch-
up growth
belum
complete.
Malnutri
tion
strongly
associate
d dengan
poor
motor
developm
ent pre-
operasi
(p=0,04;
Mean
Bayley
score
79,5±17,
5).
Growth
comparab
le antara
cyanotic/a
cyanotic
dan
dengan/ta
npa Down
syndrome.
da Silva et Growth Populasi: Cross- Pengukur Antropo
al. (2007) and Anak ≤1 sectional an metri
Nutrition tahun descriptiv antropom menunju
al Status dengan e etri (BB, kkan
of CHD PB, LK, undernut
Children belum skinfold rition:
with operasi. thickness) mean
CHD Sampel: ; Z-scores: BB/U z-
135 anak BB/U, score di
(66,7% PB/U, bawah
male) BB/PB; cutoff (-2).
Logistic Variables
regressio signifika
n analysis n untuk
malnutrit
ion: sex,
type of
disease,
birth
weight,
birth
length,
subscapul
ar &
triceps
thickness,
cephalic
circumfer
ence.
Boys:
acute
malnutriti
on lebih
prevalent
(weight-
for-age
lebih
terganggu
). Girls:
chronic
malnutriti
on risk
lebih
tinggi
(height-
for-age
lebih
rendah).
Herridge Feeding Populasi: Narrative Komprehe Prevalen
et al. the Child Review review nsif si
(2021) with narrative dengan review: undernut
CHD: A dari Medline/P determina rition:
Narrative literature ubMed nts 33-52% di
Review 1980-June search nutritiona well-
2020 l status, resourced
tentang feeding settings;
nutrition challenge ~92% di
pada s, resource-
CHD. perioperat limited
Study ive conditions
designs: feeding (60%
case practices, severe).
reports, complicati Risiko
case on tinggi:
series, managem infants
cohort ent (80%
studies, acute
RCTs malnutriti
on),
stunting
(2/3
pasien).
Cyanotic
vs
Acyanoti
c: growth
failure
80% vs
45%.
Determin
ants poor
intake:
feeding
difficulties
50%,
structural
GI
anomalies
,
prolonged
fasting,
GERD.
Strategi:
prioritize
human
milk, high
caloric
density
feeds,
enteral
tubes,
parenteral
nutrition,
 medical
therapy.
Indirect
calorimetr
y untuk
assess
energy
requireme
nts.
Ghazi & Pediatric Populasi: Book Coverage: Komprehe
Ghaemi Swallowi Review review anatomy- nsif
(2021) ng and buku (3rd dengan embryolo resource
Feeding edition, assessme gy, untuk
Assessme 2020) nt physiolog assessme
nt and oleh comprehe y nt dan
Manage Arvedson, nsive swallowin managem
ment Brodsky, g, ent FSD
(Book Lefton- clinical/in pada
Review) Greif strumenta multiple
tentang l pediatric
feeding/s evaluation populatio
wallowing (FEES, ns
problems VFSS, termasuk
pada ultrasoun cardiac.
pediatric d), Chapters
interventi 1-8:
on anatomy,
strategies, physiolog
case y,
reports evaluation
methods.
Chapters
9-13:
interventi
ons,
aspiration
managem
ent,
drooling,
genetic
considerat
ions,
behavioral
issues.
Recomm
ended
untuk:
speech
pathologis
ts,
pediatrici
ans,
gastroent
erologists,
occupatio
nal
therapists
, nurses,
lactation
consultant
s,
families.
Malnutriti Malnutri Populasi: Descriptiv Assessme Data
on in tion in Anak-anak e study nt prevalenc
Belgian Belgian dengan malnutriti e
Children Children PJB di on status, malnutriti
with CHD with Belgia. prevalenc on pada
(Author Congenit Data dari e analysis, CHD
tidak al Heart Belgian compariso populatio
teridentifi Disease pediatric n antara n di
kasi pada populatio different Belgia
excerpt) n CHD menunjuk
types kan
undernut
rition
lebih
severe
pada
multiple
heart
defects
dibandin
g single
defects.
Nutritiona
l status
worse
pada
acyanotic
lesions
dalam
beberapa
subgroup.
Monitorin
g growth
dan
feeding
assessme
nt adalah
essential
dalam
managem
ent.

Kesimpulan Umum
1. Prevalensi Malnutrisi/Failure to Thrive (FTT):

o 30-92% prevalensi undernutrition (tergantung setting kesehatan)

o FTT lebih tinggi pada CHD asianotik (72,2%) dibanding sianotik
(42,9%)
 o Acute malnutrition tinggi pada infants (80%)
o Stunting terjadi pada 2/3 pasien
2. Faktor-Faktor Penyebab Undernutrition:

o Asupan kalori inadekuat (feeding difficulties)

o Increased energy expenditure
o Malabsorpsi dan altered GI perfusion
o Breathing-swallowing coordination difficulties
o Gastroesophageal reflux (GERD)
o Fatigue dan reduced endurance
3. Perbedaan Lesi Jantung:

o HLHS: Growth restriction lebih severe; waktu mencapai full

caloric intake 24 hari vs d-TGA 12 hari
o Asianotik vs Sianotik: Perbedaan pattern, asianotik lebih affect
weight; sianotik affect weight dan length equally
o Cyanotic disease: growth failure 80% vs acyanotic 45%
4. Komplikasi Feeding:

o Feeding swallowing disorders: 42,9% pooled prevalence

o Aspiration risk: 32,9%
o Nasogastric tube complications pada 48% HLHS patients vs 4% d-
TGA patients
5. Strategi Manajemen Nutrisi:

o Prioritize human milk

o High caloric density feeds
o Enteral feeding tubes (NGT/GTT) saat diperlukan
o Parenteral nutrition untuk supplementation
o Medical therapy untuk feeding intolerance
o Home monitoring programs untuk interstage surveillance
o Early intervention nutritional
6. Impact on Outcomes:

o Malnutrition associated dengan poor motor development

o Preoperative growth deficit linked ke worse surgical outcomes
o Post-operative complications reduced dengan good preoperative
nutritional status
o Regular growth monitoring essential untuk early detection dan
intervention
Referensi

[1] Sjarif, D.R., Anggriawan, S.L., Putra, S.T., & Djer, M.M. (2011).
Anthropometric profiles of children with congenital heart disease. Med J
Indones, 20, 40-45.

[2] Davis, D., Davis, S., Cotman, K., Worley, S., Londrico, D., Kenny, D., &
Harrison, A.M. (2008). Feeding difficulties and growth delay in children with
hypoplastic left heart syndrome versus d-transposition of the great arteries.
Pediatr Cardiol, 29, 328-333.

[3] Hehir, D.A., Cooper, D.S., Walters, E.M., & Ghanayem, N.S. (2011). Feeding,
growth, nutrition, and optimal interstage surveillance for infants with
hypoplastic left heart syndrome. Cardiology in the Young, 21(Suppl. 2), 59-64.

[4] Kołodziej, M., & Skulimowska, J. (2024). A systematic review of clinical

practice guidelines on the management of malnutrition in children with
congenital heart disease. Nutrients, 16(16), 2778.

[5] Norman, V., Zühlke, L., Murray, K., & Morrow, B. (2022). Prevalence of
feeding and swallowing disorders in congenital heart disease: A scoping review.
Front Pediatr, 10, 843023.

[6] Chen, C.W., Li, C.Y., & Wang, J.K. (2004). Growth and development of
children with congenital heart disease. J Adv Nurs, 47(3), 260-269.

[7] Smith, R., Ntsiea, V., Brown, S., & Potterton, J. (2024). Undernutrition in
young children with congenital heart disease undergoing cardiac surgery in a
low-income environment. BMC Pediatrics, 24, 73.

[8] da Silva, V.M., Lopes, M.V.O., & de Araujo, T.L. (2007). Growth and
nutritional status of children with congenital heart disease. J Cardiovasc Nurs,
22(5), 390-396.

[9] Herridge, J., Tedesco-Bruce, A., Gray, S., & Floh, A.A. (2021). Feeding the
child with congenital heart disease: A narrative review. Pediatr Med, 4, 7.

[10] Ghazi, S.H., & Ghaemi, H. (2021). Pediatric swallowing and feeding
assessment and management (book review). World Nutrition, 12(3), 115-116.