Perbandingan Mortalitas Pasien Anak dengan Acute Respiratory Distress Syndrome yang Menggunakan Delta Pressure Tinggi dan Rendah

Tressa Bayu Bramantyo, Sri Martuti, Pudjiastuti Pudjiastuti

Sari


Latar belakang. Strategi ventilasi protektif paru (protective lung strategy) direkomendasikan dalam penanganan pasien acute respiratory distress syndrome (ARDS). Strategi tersebut mencakup pembatasan PEEP dan delta pressure pada penggunaan ventilator untuk mencegah mortalitas. Pembatasan delta pressure ≤13 mmHg diharapkan dapat menurunkan angka mortalitas pasien ARDS dengan ventilator.
Tujuan. Mengetahui perbandingan mortalitas pasien anak dengan ARDS yang menggunakan delta pressure tinggi dan rendah.
Metode. Penelusuran rekam medis pasien anak berusia 1 bulan-18 tahun yang menderita ARDS yang dirawat di PICU dengan menggunakan ventilator.
Hasil. Studi cross sectional dari bulan September 2016 sampai dengan Maret 2017 terhadap 32 pasien anak berumur 1 bulan-18 tahun yang menderita ARDS, didapatkan hasil bahwa mortalitas pasien anak dengan ARDS lebih tinggi pada penggunaan setting ventilator dengan delta pressure tinggi (ΔP>13 cmH2O) dibandingkan dengan yang menggunakan pengaturan ventilator dengan delta pressure yang rendah (ΔP≤13 cmH2O) (p<0,001, OR 45,00 (IK95%: 5,47-370,02).
Kesimpulan. Pasien anak dengan ARDS yang menggunakan setting ventilator dengan delta pressure rendah, mortalitasnya lebih rendah dibandingkan dengan yang menggunakan pengaturan ventilator dengan delta pressure tinggi.


Kata Kunci


ARDS; pengaturan ventilator; delta pressure; mortalitas; anak

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Referensi


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DOI: http://dx.doi.org/10.14238/sp19.3.2017.156-60

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