Angka Kejadian Ventilasi Mekanis Berkepanjangan pada Pasien Pasca bedah Pintas Arteri Koroner di RSUP Dr. Hasan Sadikin Bandung Tahun 2014–2016
Abstract
Bedah Pintas Arteri Koroner adalah salah satu tindakan intervensi untuk mengembalikan perfusi koroner. Pascabedah jantung membutuhkan bantuan ventilasi mekanis yang apabila berkepanjangan akan meningkatkan mortalitas dan morbiditas. Tujuan penelitian ini adalah mengetahui angka kejadian ventilasi mekanis berkepanjangan pascabedah pintas arteri koroner berdasar atas usia, jenis kelamin, fraksi ejeksi ventrikel kiri preoperatif, waktu pintas jantung paru, kadar hemoglobin pascaoperasi, dan komorbiditas pada pasien di RSUP Dr. Hasan Sadikin Bandung tahun 2014–2016. Metode yang digunakan adalah deskriptif observasional dengan pendekatan retrospektif berdasar data rekam medis. Dari hasil penelitian ini diperoleh hasil angka kejadian ventilasi mekanis berkepanjangan adalah 69,7%. Penelitian ini menunjukkan angka kejadian ventilasi mekanis berkepanjangan pascabedah pintas arteri koroner berdasarkan usia ≤65 tahun adalah 68,1%, usia >65 tahun 75,7%, laki-laki 69,1%, perempuan 73,1%, fraksi ejeksi >50% sebesar 73,3%, fraksi ejeksi sebesar 66,3%, waktu pintas jantung paru ≤90 menit 47,7%, waktu pintas jantung paru >90 menit 81,6%, kadar hemoglobin pascaoperasi <10 g/dL sebesar 75%, kadar hemoglobin ≥10 g/dL sebesar 66,9%, pasien dengan komorbiditas 69,7% dan tanpa komorbiditas 69,8%. Sebagai simpulan, didapatkan angka kejadian ventilasi mekanis berkepanjangan lebih tinggi pada pasien usia >65 tahun, pasien perempuan, pasien dengan fraksi ejeksi ≤50%, waktu pintas jantung paru >90 menit dan kadar Hb pascaoperasi <10 g/dL
Incidence Rates of Prolonged Mechanical Ventilation in Patients Post Coronary Arterial Bypass Grafting at Dr. Hasan Sadikin General Hospital Bandung in 2014–2016
Coronary Artery Bypass Grafting (CABG) is an intervention to restore coronary perfusions. Postcardiac surgery requires mechanical ventilation, which, if prolonged, will increase morbidity and mortality.The purpose of this study was to determine the incidence of prolonged mechanical ventilation post-CABG based on age, sex, preoperative left ventricular ejection fraction (LVEF), cardio pulmonary bypass (CPB) time, postoperative hemoglobin levels, and patient comorbidity at Dr. Hasan Sadikin General Hospital Bandung in 2014-2016. The method used in this study was an observational descriptive retrospective approach based on medical records. The results of this study showed the incidence of prolonged mechanical ventilation incidence was 69.7%. This study showed that incidence of post-CABG prolonged mechanical ventilation based on age ≤65 years old were 68.1%, age >65 years old were 75.7%, men were 69.1%, women were 73.1%, LVEF ≤50% were 73.3%, LVEF >50% were 66.3%, CPB time <90 minutes were 47.5%, CPB time >90 minutes were 81.6%, postoperative hemoglobin level <10 g/dL were 75%, hemoglobin level ≥10 g/dL were 66.9%, patients with comorbidities were 69.7% and without comorbidities were 69.8%. In conclusion, there was higher incidence of prolonged mechanical ventilation in patients >65 years old, woman, with LVEF ≤50%, CPB time >90 minutes and postoperative hemoglobin level <10 g/dL.
Keywords
Full Text:
PDFReferences
Sasayama S. Heart disease in asia. Circulation. 2008;118:2669–71.
American Heart Association. Asian & Pacific Islanders and cardiovascular disease. Statistical Fact Sheet 2013 Update. 2013.
Suleiman MS, Zacharowski K, Angelini GD. Inflammatory response and cardioprotection during open-heart surgery: the importance of anaesthetics. Br J Pharmacol. 2008;153:21–33.
Spivack SD, Shinozaki T, Albertini JJ, Deane R. Preoperative prediction of postoperative respiratory outcome. CHEST. 1996;109:1222–30.
Flegler S, Paro FM. Factors associated with intubation time and ICU stay after CABG. Braz J Cardiovasc Surg. 2015;30(6):631–5.
Cislaghi F, Condemi AM, Corona A. Predictors of prolonged mechanical ventilation in a cohort of 3,269 CABG patients. Minerva Anestesiol. 2007;73:615–21.
Natarajan A, Samadian S, Clark S. Coronary artery by pass surgery in elderly people. Postgrad Med Journal. 2007;83:154–15.
Sharma G, Goodwin J. Effects of aging on respiratory system physiology and immunology. Clinical Interventions in Aging. 2006;1(3):253–60.
Blasberg JD, Schwartz GS, Balaram SK. The role of gender in coronary surgery. Eur J Cardiothorac Surg. 2011;40:715–21.
Konstam MA, Abboud FM. Eection Fraction: misunderstood and overrated (changing the paradigm in categorizing heart failure). Circulation. 2017;135:717–9.
Capdeville M, Lee JH, Taylor AL. Effect of gender on fast-rack recovery after coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2001;2(15):146–51.
Steidl S. The Adverse Effects of the Cardiopulmonary Bypass Machine. Liberty University. 2011;1–35.
Grocott HP, Smith MS, Mangano CT. Cardiopulmonary Bypass management and Organ Protection. Dalam: Kaplan JA, Reich D, Savino JS, penyunting. Kaplan’s Cardiac Anesthesia. Edisi ke-6. Missouri: Elsevier Saunders; 2011. hlm. 862–4.
Rodrigues CD, Oliveira RA, Soares OM, Figueiredo LC, Sebastião Araújo, Dragosavac D. Lung injury and mechanical ventilation in cardiac surgery: a review. Rev Bras Cir Cardiov. 2010;22(4):375–83.
McLellan SA, Walsh TS. Osygen delivery and haemoglobin. Br J Anaesth. 2004;4(4):123–6.
Hébert PC, Blajchman MA, Cook DJ, Yetisir E, Wells G, Marshall J, dkk. Do blood transfusions improve outcome related to mechanical ventilation? CHEST. 2001;119:1850–7.
Hébert PC, Tinmouth A, Corwin HL. Controversies in RBC transfusion in the critically ill. CHEST. 2007;131:1583–90.
Ji Q, Chi L, Mei Y, Wang X, Feng J, Cai J, dkk. Risk factors for late extubation after coronary artery bypass grafting. Heart and Lung. 2010;4(39):275–82.
Ji Q, Duan Q, Wang X, Cai J, Zhou Y, Feng J, dkk. Risk factors for ventilator dependency following coronary artery bypass grafting. Int J. Med. Sci. 2012;9(4):306–10.
Rezaianzadeh A, Maghsoudi B, Tabatabaee H, Keshavarzi S, Bagheri Z, Sajedianfard J. Factors associated with extubation time in coronary artery bypass grafting patients. Peer J. 2015:1–11
Rajaei S, Dabbagh A. Risk factors for postoperative respiratory mortality and morbidity in patients undergoing coronary artery bypass grafting. Anesth Pain. 2012;2(2):60–5.
DOI: https://doi.org/10.15851/jap.v8n1.2015
Article Metrics
Abstract view : 652 timesPDF - 404 times
This Journal indexed by
JAP is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
View My Stats