Hiperkapnia sebagai Prediktor Mortalitas Pasien COVID-19

Indra Wijaya, Ezra Oktaliansah, M. Erias Erlangga, Iwan Fuadi, Erwin Pradian, Indriasari Indriasari

Abstract


Virus SARS-CoV-2 menyebabkan penyakit pernapasan akut yang disebut COVID-19 dan menyebabkan pandemi global. Proses aktivasi trombosis intravaskular pada COVID-19 menyebabkan komplikasi trombosis mikrovaskular dan makrovaskular sehingga terjadi peningkatan ruang mati paru dan meningkatkan kadar PaCO2. Hiperkapnia menyebabkan banyak perubahan fisiologis dalam tubuh meliputi sirkulasi paru dan sistemik dan meningkatkan risiko mortalitas pasien ARDS. Penelitian ini bertujuan mengetahui apakah hiperkapnia merupakan prediktor mortalitas pasien COVID-19. Penelitian dilakukan berdasarkan data pasien pada periode Maret 2020–Desember 2021. Penelitian ini adalah penelitian analitik observasional dengan rancangan kohort retrospektif. Data PaCO2 pasien diambil saat hari pertama pasien dirawat di ICU RSUP Dr. Hasan Sadikin dan status mortalitas pasien di hari rawat ke-7 dan 28 hari. Analisis statistik yang digunakan adalah analisis bivariabel simple regression logistic. Hasil analisis statistik diperoleh nilai p< 0,05 dengan OR = 7,07 (CI 2,519–19,850) pada mortalitas hari ke-7, dan nilai p< 0,05 OR 44,33 (CI 9,182–214,062) pada mortalitas hari ke-28. Simpulan penelitian ini menunjukkan bahwa hiperkapnia merupakan prediktor mortalitas hari ke-7 dan ke-28 perawatan pada pasien COVID-19 yang dirawat di ruang rawat intensif isolasi.


Hypercapnia as Mortality Predictor in COVID-19 Patients

The SARS-CoV-2 virus causes COVID-19, an acute respiratory illness that caused a global pandemic. The activation of intravascular thrombosis in COVID-19 results in microvascular and macrovascular thrombosis complications, which increase lung dead space and PaCO2 levels. The hypercapnia condition causes many physiological changes in the body, including pulmonary and systemic circulation. It is known to increase the mortality risk in ARDS patients admitted to the Intensive Care Unit (ICU). This study aimed to determine if hypercapnia was a mortality predictor in COVID-19 patients treated in the isolation intensive care unit at Hasan Sadikin Hospital in Bandung. This observational analytic study used an observational analytic design with a retrospective cohort. The patient's PaCO2 data was collected on the first day of hospitalization in the ICU, and the patient's mortality status was collected on the 7th and 28th days of hospitalization. According to the statistical analysis, hypercapnia was associated with higher mortality, OR 7.07 (CI 2.519–19.850) on the 7th-day mortality and 44.33 (CI 9.182–214.062) on the 28th-day mortality, P value < 0.05. In conclusion, hypercapnia is a mortality predictor on the 7th and 28th days of treatment in COVID-19 patients treated in the isolation intensive care unit.

 

Keywords


COVID-19, hiperkapnia, mortalitas, PaCO2

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References


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DOI: https://doi.org/10.15851/jap.v10n3.3048

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