Lama Penggunaan Ventilator, ICU-LOS, dan Mortalitas Pasien Ventilated Hospital Acquired Pneumonia dan Ventilated Community Acquired Pneumonia di GICU RSUP Dr. Hasan Sadikin Periode Januari–Desember 2021

Sugianto Parulian Simanjuntak, Erwin Pradian, Ruli Herman Sitanggang

Abstract


Ventilated hospital-acquired pneumonia (V-HAP) dan ventilated community-acquired pneumonia (V-CAP) merupakan subtipe klinis penyakit hospital-acquired pneumonia dan community-acquired pneumonia yang ditatalaksana dengan ventilasi mekanik di ICU. Penelitian yang mengeksplorasi karakteristik umum dan luaran kedua kategori pasien tersebut masih sangat terbatas. Penelitian observasional retrospektif ini menganalisis rekam medis pasien V-HAP dan V-CAP berusia 18 tahun ke atas yang dirawat di GICU Rumah Sakit Umum Pusat Dr. Hasan Sadikin, Bandung antara Januari–Desember 2021. Terdapat 23 pasien V-HAP dan 21 pasien V-CAP. Ditemukan bahwa pasien V-HAP lebih lama menggunakan ventilator (rerata: 16,33±9,88 hari) dibanding dengan V-CAP (rerata: 8,25±4,92 hari). Pasien V-HAP juga lebih lama dirawat di ICU (rerata ICU-LOS: 19,33±13,42 hari) dibanding dengan V-CAP (rerata ICU LOS: 9±4,74 hari). Mortalitas yang tinggi pada kelompok V-HAP (87%) dan V-CAP (81%) dipengaruhi oleh komorbiditas dan kondisi dasar pasien. Pada biakan sputum juga ditemukan lebih banyak kuman gram negatif yang didominasi multi drug resistant organism (MDRO), yaitu sebanyak 93% pada V-HAP dan 78% pada V-CAP. Pasien V-HAP di ICU memiliki durasi penggunaan ventilator dan perawatan ICU yang lebih lama serta tingkat mortalitas yang tinggi dibanding dengan pasien V-CAP dan dengan prevalensi kuman gram negatif resisten obat yang lebih dominan.


Keywords


ICU; LOS; mortalitas; pneumonia; ventilator

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References


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DOI: https://doi.org/10.15851/jap.v12n1.3551

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