Perbandingan Kadar Alanin Aminotransferase (ALT) dan Aspartat Aminotransferase (AST) Sebelum dan Sesudah Pemberian Nutrisi Parenteral pada Anak Sakit Kritis

Abstract

Background: Critically ill children in the pediatric intensive care unit tend to be malnourished since admission or during treatment so they need to receive parenteral nutrition. The incidence of worsening liver function after parenteral nutrition is 60%. Liver disease can be progressive, irreversible and fatal on long-term parenteral nutrition. Objective: To compare the increased levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) before and after parenteral nutrition in critically ill children.Methods: The study was conducted cross-sectionally by looking at secondary data, namely the medical records of patients treated in intensive care units receiving parenteral nutrition for the period July 2018 to July 2021. The samples were selected using a total sampling of 163 samples who received parenteral nutrition and then AST and ALT examinations were performed. Data analysis used paired T test and Wilcoxon Signed Rank Test. Results: The results of the Wilcoxon Signed Rank test on AST values before and after parenteral nutrition showed an increase in the median AST after parenteral nutrition was 2 times the previous value. The mean value of ALT levels before parenteral nutrition was 19.28 ± 6.99 U/L and increased after administration was 42.45 ± 15.41 U/L. The results of the paired T test for assessing ALT levels before and after parenteral nutrition showed p value = 0.001. Therefore, there was an increase in AST and ALT levels after parenteral nutrition. Conclusion: There was an increase in ALT and AST levels after parenteral nutrition in critically ill children.