Tinjauan Pustaka: Alkalosis Respiratorik pada COVID-19: Sleeping with the "Silent Devil."

Made Yudha Asrithari Dewi, Putu Agus Surya Panji

Abstract


Dewasa ini krisis pertumbuhan penyakit coronavirus disease (COVID-19) telah menekan sistem kesehatan secara global bahkan lebih dari sebelumnya, menyebabkan kebutuhan peningkatan kapasitas unit perawatan intensif dalam menangani jumlah pasien kritis yang meningkat secara tajam. Gagal napas pada COVID-19 diperburuk oleh keadaan hipoksemia dan dapat memburuk menjadi acute respiratory distress syndrome (ARDS) yang segera membutuhkan terapi suplementasi oksigen. Menilai kebutuhan memulai terapi oksigen dapat dilakukan salah satunya dengan analisis gas darah untuk mengevaluasi gangguan asam basa terutama pada perjalanan awal COVID-19 simtomatis berat. Silent hypoxemia sebagai gejala COVID-19 yang mematikan merupakan sebuah tantangan dalam kegawatdaruratan COVID-19. Hipoksemia berat akibat hiperventilasi tanpa gangguan pernapasan akan menunjukkan gambaran hasil analisis gas darah berupa alkalosis respiratorik sebagai upaya kompensasi penurunan kadar PaCO2 untuk meningkatkan saturasi. Pergeseran kurva disosiasi ke kiri menyebabkan peningkatan afinitas Hb-O2 untuk memfasilitasi kebutuhan oksigen. Maka dari itu, tenaga kesehatan harus memperhatikan bukan hanya keadaan umum pasien melainkan juga laju pernapasan dan melihat tanda hiperventilasi untuk mengetahui gangguan asam basa melalui analisis gas darah agar dapat mencegah komplikasi alkalosis respiratorik.

 

Literature Review: Respiratory Alkalosis in COVID-19: Sleeping with the Silent Demon

Today the growing crisis of coronavirus disease (COVID-19) has urged the health system globally even more than ever before, leading to the need to increase the capacity of intensive care units in dealing with the sharply increasing number of critically ill patients. Respiratory failure in COVID-19, exacerbated by hypoxemia, can worsen into acute respiratory distress syndrome (ARDS), requiring immediate oxygen supplementation therapy. The need to start oxygen therapy can be assessed by examining blood gas analysis to evaluate the presence of acid-base disorders, especially in the early progress of severe symptoms of COVID-19. Silent hypoxemia, a deadly symptom of COVID-19, is a challenge in the emergency of COVID-19. Severe hypoxemia due to hyperventilation in the absence of respiratory disorders will show a picture of the results of blood gas analysis in the form of respiratory alkalosis to compensate for decreased PaCO2 levels to increase saturation. The left shift of the dissociation curve leads to an increase in Hb-O2 affinity to facilitate oxygen needs. Hence, healthcare workers should pay attention to the patient's general condition and breathing rate. Besides, looking for the signs of hyperventilation to find the presence of acid-base disorders through analysis of blood gases to prevent respiratory alkalosis complications.


Keywords


Alkalosis respiratorik; analisis gas darah; COVID-19; gangguan asam basa

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References


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DOI: https://doi.org/10.15851/jap.v10n2.2620

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