Mortalitas Asidosis Metabolik Laktat dan Non-laktat di Unit Perawatan Intensif Pediatrik RSUP Sanglah

Romy Windiyanto, Suparyatha I B Gd, Sidiartha IGL, Budi Hartawan I N

Sari


Latar belakang. Hiperlaktasemia terjadi pada pasien sakit berat disebabkan karena peningkatan produksi
laktat dan hambatan pengeluaran laktat. Konsentrasi laktat serum >5 mmol/L disertai pH darah <7,35
disebut asidosis laktat. Prognosis asidosis metabolik laktat lebih buruk dibandingkan asidosis metabolik
non-laktat meskipun kadar asidosis lebih ringan.
Tujuan. Membandingkan angka mortalitas pasien asidosis metabolik laktat dan non-laktat yang dirawat di Unit
Perawatan Intensif Pediatrik RSUP Sanglah, serta mengetahui peran beberapa parameter laboratotium.
Metode. Rancangan penelitian kohort prospektif dengan pembanding internal. Pasien yang mengalami
asidosis metabolik, dianalisis dan angka mortalitas dibandingkan antara asidosis metabolik laktat dan
asidosis metabolik non-laktat. Risiko relatif dihitung untuk mencari hubungan antara asidosis metabolik
laktat dengan mortalitas. Hubungan antara beberapa variabel independen terhadap variabel dependen
dilakukan analisis multivariat regresi logistik.
Hasil. Di antara 80 pasien, terdapat perbedaan bermakna mortalitas kelompok asidosis metabolik laktat
(p= 0,025; RR= 2,81; IK 95% 1,129-6,991). Kadar laktat (p: 0.007; IK 95% 0.037-0.121) dan pH darah
(p: 0.013; IK 95% -2.264- -0.361) menunjukkan hubungan yang bermakna terhadap mortalitas. Kadar
laktat >10 mmol/L dan pH darah <7,1 memperlihatkan mortalitas 100%
Kesimpulan. Asidosis metabolik laktat memiliki risiko relatif 2,81 terhadap mortalitas, kadar laktat dan
pH darah memiliki hubungan dengan kejadian mortalitas. Terdapat perbedaan proporsi mortalitas pada
kadar laktat >10 mmol/L dan pH darah <7,1.


Kata Kunci


mortalitas; asidosis metabolik laktat; unit perawatan intensif pediatrik

Teks Lengkap:

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Referensi


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DOI: http://dx.doi.org/10.14238/sp13.5.2012.351-6

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