Penggunaan Steroid dalam Tata Laksana Sepsis Analisis Kasus Berbasis Bukti

Ariani Dewi Widodo, Alan Roland Tumbelaka

Sari


Sepsis merupakan salah satu penyebab kematian terbanyak di rumah sakit dengan mortalitas 50%-60%,
meskipun dengan terapi antibiotik dan tata laksana suportif yang adekuat. Steroid merupakan pilihan
terapi pada sepsis yang masih kontroversial sejak empatpuluh tahun yang lalu. Muncul pertanyaan klinis,
apakah pemberian steroid memberikan respon terapi lebih baik dan meningkatkan kesintasan pada sepsis
dibandingkan terapi konvensional? Ilustrasi kasus dan penelusuran kepustakaan menggunakan instrumen
pencari Pubmed, Highwire, dan Cochrane Library sesuai kata kunci.
Pada penelusuran didapatkan 16 artikel yang relevan 4 telaah sistematik, 9 uji klinis acak terkontrol, 1 kohort,
dan 2 review. Levels of evidence ditentukan berdasarkan klasifikasi Oxford atau Methodologic Quality
Form dari Cronin. Kortikosteroid dosis rendah jangka panjang sebaiknya diberikan pada semua syok septik
dependen vasopresor. Kortikosteroid tidak dianjurkan pada sepsis tanpa syok. Kortikosteroid dosis tinggi
dapat membahayakan pada sepsis berat dan syok septik. Steroid diberikan berdasarkan keputusan klinis,
bukan hasil laboratorium maupun protokol. Kortikosteroid memperbaiki keadaan syok septik persisten
dan lebih cepat memulihkan gangguan hemodinamik, sehingga menurunkan mortalitas


Kata Kunci


sepsis; syok septik; kortikosteroid; kesintasan

Teks Lengkap:

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Referensi


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DOI: http://dx.doi.org/10.14238/sp11.6.2010.387-94

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