Hubungan Kadar Laktat Plasma dengan Derajat Disfungsi Organ Berdasarkan Skor PELOD pada Anak Sakit Kritis
Sari
Latar belakang. Peningkatan kadar laktat menunjukkan hipoksia jaringan dan bila berlangsung lama akan menyebabkan kematian sel dan disfungsi organ. Skor PELOD (pediatric logistic organ dysfunction) merupakan skor komposisi yang dapat digunakan untuk menilai derajat disfungsi organ dan prediksi kematian.
Tujuan. Mengetahui hubungan kadar laktat plasma dengan derajat disfungsi organ berdasarkan skor PELOD pada anak sakit kritis.
Metode. Penelitian observasional analitik dengan rancangan cross sectional di Bagian Ilmu Kesehatan Anak RS dr. Hasan Sadikin Bandung pada April-Mei 2008. Pasien anak sakit kritis usia 1 bulan sampai 14 tahun dipilih secara konsekutif. Untuk menentukan korelasi antara kadar laktat plasma dan derajat disfungsi organ dilakukan dengan Spearman rank correlation. Kadar laktat dikelompokkan menjadi 2 kelompok, yaitu kadar laktat <2 mmol/L dan kadar laktat ≥2 mmol/L. Perbandingan antara kelompok kadar laktat dan distribusi umur, skor PELOD, dan jumlah disfungsi organ dilakukan uji Mann-Whitney. Variabel hipoperfusi dilakukan dengan uji chi-square. Hubungan antar variabel dengan regresi logistik.
Hasil. Didapatkan 45 subjek dengan umur rata-rata 48,7 bulan. Jenis kasus kegawatan terbanyak adalah kegawatan kardiovaskular. Kadar laktat rata-rata 3,45 mmol/L dan rata-rata mengalami 3 disfungsi organ. Terdapat hubungan positif yang bermakna antara kadar laktat plasma dan derajat disfungsi organ berdasarkan skor PELOD (rs=0,54 p=0,001), juga dengan jumlah organ yang mengalami disfungsi. Kadar laktat plasma ≥3,3 mmol/L berhubungan dengan keadaan hipoperfusi.
Kesimpulan. Terdapat hubungan antara kadar laktat plasma dan derajat disfungsi organ berdasarkan skor PELOD
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DOI: http://dx.doi.org/10.14238/sp10.4.2008.280-4
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