Departemen Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung

Tirto Hartono, Ezra Oktaliansah, Ardi Zulfariansyah

Abstract


Pasien sakit kritis adalah pasien dengan kondisi mengancam nyawa yang membutuhkan penanganan khusus di ruang rawat intensif (intensive care unit; ICU). Hampir semua pasien kritis yang dirawat di ICU memiliki beberapa faktor risiko yang meningkatkan venous thromboembolism (VTE). Venous thromboembolism merupakan komplikasi yang tersembunyi pada pasien sakit kritis yang dapat meningkatkan angka morbiditas dan mortalitas. Venous thromboembolism dapat dicegah dengan tromboprofilaksis yang sesuai dan adekuat. Pedoman pencegahan VTE dikembangkan dalam beberapa dekade salah satunya oleh American College of Chest Physicians (ACCP). Tujuan penelitian ini mengetahui kepatuhan berdasar ketepatan dan kecukupan pemberian tromboprofilaksis terhadap pedoman ACCP. Penelitian deskiripsi observasional retrospektif dilakukan pada Oktober–Desember 2018 terhadap 284 pasien yang dirawat di Unit Perawatan Intensif Rumah Sakit Dr. Hasan Sadikin Bandung periode Januari–Desember 2016. Secara keseluruhan proporsi pasien di ICU yang mendapatkan tromboprofilaksis, yaitu 36,1%. Angka kepatuhan pemberian profilaksis VTE di ICU berdasar pedoman ACCP adalah 21,5%. Pemberian profilaksis VTE yang tidak adekuat terdapat pada 12,4% pasien, sedangkan pemberian profilaksis yang tidak sesuai terdapat pada 2,2% pasien. Simpulan, kepatuhan pemberian tromboprofilaksis terhadap pedoman yang diterbitkan ACCP masih rendah.


Keywords


American College of Chest Physicians, kepatuhan; tromboprofilaksis; venous thromboembolism

References


Adriance SM, Murphy CV. Prophylaxis and treatment of venous thromboembolism in critically ill. Int J Crit Illn Inj Sci. 2013;3:143–51.

Moser KM. Venous thromboembolism. Dalam: Kluwer W, penyunting. Marino’s Edisi ke-4. The ICU Book. Philadelphia: Lippincott Williams & Wilkins. 2014. Hlm. 97–105.

Kaushansky, K, Lichtman MA, Beutler E, Kipps TJ, Seligsohn U, Prchal JT. Venous thrombosis. Dalam: Raskob GE, Hull RD; Pineo GF, penyunting. Williams hematology. Edisi ke-8. China: The McGraw-Hill Companies, Inc.P; 2010. hlm. 2700–20.

Boodi M, Peris A. Deep vein thrombosis on intensive care. Adv Exp Med Biol. Switzerland. 2015;2:167–81.

Hutajulu SV. Thromboembolism prophylatic. Dalam: Pangalila FJV, Mansjoer A, penyunting. Penatalaksanaan sepsis dan syok septik (optimalisasi Fashugbid). Jakarta: Perdici; 2017. hlm. 28–32.

Ting Y, Dylan M, Lin J, Dubois R. Hospitals’ compliance with prophylaxis guidelines for venous thromboembolism. Am I Health-Syst Pharm. 2007;24:69–74.

Minet C, Potton L, Bonadona A, Roy RH, Somohano CA, Lugosi M, dkk. Venous thromboembolism in the ICU: main characteristics, diagnosis and thromboprophylaxis. BioMed Central. Crit Care. 2015;19:287.

Cohen AT, Tapson VF, Bergmann JF, Goldhaber SZ, Kakkar AK, Deslandes B, dkk. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study. Lancet. 2008;371:387–93.

Essam AE, Sharif G, Al Hameed F. Venous thromboembolism related mortality and morbidity in King Fahd General Hospital, Jeddah, Kingdom of Saudi Arabia. Ann Thorac Med. 2011;6:193–8.

Bauer KA, Lip GYH. Overview of the causes of venous thrombosis. UpToDate. 2004;12:166.

Heraudeau A, Delluc A, Henaff ML, Lacut K, Leroyer C, Desreus B, dkk. Risk of venous thromboembolism in association with factor V leiden in cancer patient. Plos one. Barcelona. 2018;13:5.

Guyatt GH, Aki EA, Crowther M, Agnelli G, Bolis G, Capussotti;s L, dkk. Executive summary: antithrombotic therapy and prevention of thrombosis. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(Suppl):7–47S.

Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J Thromb Thrombolysis. 2016;41:3–14.

Engbers MJ, Vlieg VH, Rosendaal FR. Venous thrombosis in elderly: incidence, risk and risk groups. J Thromb Haemost. 2010;8:2105–12.

Geerts WH, Bergqvist D, Pineo GF, Enoch S, Woon E. Prevention of venous thromboembolism. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2008;133(Suppl):381–453S.

King CS, Holley AB, Jackson JL, Nordstrom M, Lindblad B, Bergqvist D. Twice vs. three times daily heparin dosing for thromboembolism prophylaxis in the general medical population. a meta-analysis. Chest 2007;131:507–16.

Consortium for Spinal Cord Medicine. Prevention of venous thromboembolism in individual with spinal cord injury: clinical practice guidelines for health care provider. Top Spinal Cord Inj Rehabil. 2016;22(3):209–240.

Imberti D, Ageno W. A survey of thromboprophylaxis management in patients with major trauma. Pathophysiol Haemost Thromb. 2005;34:249–54.

Garcia DA, Baglin TP, Weitz JI, Samama MM. Parenteral anticoagulants. Antithrombotic therapy and prevention of thrombosis. American

College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Chest. 2012;141(Suppl):24–43S.

Manoucheri R, Fallahi MJ. Adherence to venous thromboprophylaxis guidelines for medical and surgical inpatients of teaching hospital, Shiraz-Iran. National Institute of tuberculosis and lung disease. Iran: Tanaffos. 2015;14:17–26.




DOI: https://doi.org/10.15851/jap.v7n2.1739


 

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