Pengaruh Tes Elevasi Tungkai Secara Pasif terhadap Variasi Pletismograf untuk Penilaian Responsivitas Cairan pada Pasien yang Dilakukan Pembedahan dengan Anestesi Umum

Main Authors: Susanto, Bahtiar, Pradian, Erwin, Bisri, Tatang
Format: Article info application/pdf eJournal
Language: eng
Published: Faculty of Medicine, Universitas Padjadjaran , 2016
Subjects:
Online Access: http://journal.fk.unpad.ac.id/index.php/jap/article/view/821
http://journal.fk.unpad.ac.id/index.php/jap/article/view/821/pdf
ctrlnum article-821
fullrecord <?xml version="1.0"?> <dc schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"><title lang="en-US">Pengaruh Tes Elevasi Tungkai Secara Pasif terhadap Variasi Pletismograf untuk Penilaian Responsivitas Cairan pada Pasien yang Dilakukan Pembedahan dengan Anestesi Umum</title><creator>Susanto, Bahtiar</creator><creator>Pradian, Erwin</creator><creator>Bisri, Tatang</creator><subject lang="en-US"/><subject lang="en-US">Anestesi umum, elevasi tungkai secara pasif, responsivitas terhadap cairan, variasi pletismograf</subject><description lang="en-US">Penilaian responsivitas terhadap cairan sangat berguna untuk optimalisasi cairan perioperatif. Variasi pletismograf (respiratory variations in the pulse oximetry plethysmographic waveform amplitude; &#x2206;POP) dan elevasi tungkai secara pasif (passive leg raising; PLR) merupakan parameter dinamis yang akurat dalam menilai responsivitas terhadap cairan. Tujuan penelitian ini adalah menilai pengaruh elevasi tungkai secara pasif terhadap variasi pletismograf untuk menilai responsivitas terhadap cairan pada pasien setelah induksi anestesi umum. Penelitian ini merupakan uji klinis pada 30 pasien yang menjalani operasi dengan anestesi umum, usia 18&#x2013;60 tahun, dan status fisik American society of anesthesiologist (ASA) I atau II pada bulan Februari&#x2013;Maret 2015 di Instalasi Bedah Sentral Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian ini diuji dengan uji-t berpasangan, Wilcoxon, dan uji ANOVA. Setelah dilakukan induksi anestesi umum, variasi pletismograf dicatat sebelum, saat, dan sesudah elevasi tungkai secara pasif. Hasil penelitian menunjukkan efek elevasi tungkai secara pasif akan menurunkan variasi pletismograf. Penurunan variasi pletismograf yang signifikan pada responden yang memiliki responsivitas terhadap cairan 6/30 dengan variasi pletismograf &gt;13% sebelum dilakukan elevasi tungkai secara pasif. Perbedaan ini bermakna secara statistik (p&lt;0,05). Elevasi tungkai secara pasif akan menurunkan variasi pletismograf yang dapat digunakan untuk menilai responsivitas terhadap cairan pada pasien yang menjalani operasi dengan anestesi umum.Kata kunci: Anestesi umum, elevasi tungkai secara pasif, responsivitas terhadap cairan, variasi pletismografEffect of Passive Leg Raising Test on Respiratory Variations in Pulse Oximetry Plethysmographic Waveform in Assessing Fluid Responsiveness of Surgery Patients under General AnesthesiaFluid responsiveness assessments have shown to be an important matter in perioperative fluid optimization. Respiratory variations in pulse oximetry plethysmographic waveform amplitude (&#x2206;POP) and passive leg raising have been shown as promising indicators due to the ability to predict fluid responsiveness. The aim of this study was to assess the effect of passive leg raising (PLR) on &#x2206;POP to predict fluid responsiveness in mechanically ventilated patients after induction of general anesthesia. This was a trialon 30 patients referred for surgery under general anesthesia, aged 18&#x2013;60 years and ASA physical status I or II, during the period of February&#x2013;March 2015 at the Central Surgical Installation of Dr. Hasan Sadikin General Hospital Bandung. Patients were studied immediately after the induction of general anesthesia. This trial use the paired t test, Wilcoxon test, and ANOVA for statistical analysis. Vital signs and &#x2206;POP were recorded at baseline, before, and after PLR. PLR induced changes in &#x2206;POP with a &#x2206;POP greater than 13% compared to the initial PLR allowed discrimination between responders and nonresponders to 6/30. There was a significant decrease in &#x2206;POP in responders when compared to the nonresponders(p&lt;0.05). &#x2206;POP can be reduced by PLR and fluid responsiveness can be predicted noninvasively in mechanically ventilated patients during general anesthesia.Key words: Fluid responsiveness, general anesthesia, passive leg raising, respiratory variations in the pulse oximetry plethysmographic waveform amplitude&#xA0;DOI:&#xA0;10.15851/jap.v4n2.821</description><publisher lang="en-US">Faculty of Medicine, Universitas Padjadjaran</publisher><contributor lang="en-US"/><date>2016-09-01</date><type>Journal:Article</type><type>Other:info:eu-repo/semantics/publishedVersion</type><type>Other:</type><type>Other:</type><type>File:application/pdf</type><identifier>http://journal.fk.unpad.ac.id/index.php/jap/article/view/821</identifier><source lang="en-US">Jurnal Anestesi Perioperatif; Vol 4, No 2 (2016); 80-86</source><source lang="id-ID">Jurnal Anestesi Perioperatif; Vol 4, No 2 (2016); 80-86</source><source>2337-7909</source><language>eng</language><relation>http://journal.fk.unpad.ac.id/index.php/jap/article/view/821/pdf</relation><rights lang="en-US">Copyright (c) 2016 Jurnal Anestesi Perioperatif</rights><recordID>article-821</recordID></dc>
language eng
format Journal:Article
Journal
Other:info:eu-repo/semantics/publishedVersion
Other
Other:
File:application/pdf
File
Journal:eJournal
author Susanto, Bahtiar
Pradian, Erwin
Bisri, Tatang
title Pengaruh Tes Elevasi Tungkai Secara Pasif terhadap Variasi Pletismograf untuk Penilaian Responsivitas Cairan pada Pasien yang Dilakukan Pembedahan dengan Anestesi Umum
publisher Faculty of Medicine, Universitas Padjadjaran
publishDate 2016
topic Anestesi umum
elevasi tungkai secara pasif
responsivitas terhadap cairan
variasi pletismograf
url http://journal.fk.unpad.ac.id/index.php/jap/article/view/821
http://journal.fk.unpad.ac.id/index.php/jap/article/view/821/pdf
contents Penilaian responsivitas terhadap cairan sangat berguna untuk optimalisasi cairan perioperatif. Variasi pletismograf (respiratory variations in the pulse oximetry plethysmographic waveform amplitude; ∆POP) dan elevasi tungkai secara pasif (passive leg raising; PLR) merupakan parameter dinamis yang akurat dalam menilai responsivitas terhadap cairan. Tujuan penelitian ini adalah menilai pengaruh elevasi tungkai secara pasif terhadap variasi pletismograf untuk menilai responsivitas terhadap cairan pada pasien setelah induksi anestesi umum. Penelitian ini merupakan uji klinis pada 30 pasien yang menjalani operasi dengan anestesi umum, usia 18–60 tahun, dan status fisik American society of anesthesiologist (ASA) I atau II pada bulan Februari–Maret 2015 di Instalasi Bedah Sentral Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian ini diuji dengan uji-t berpasangan, Wilcoxon, dan uji ANOVA. Setelah dilakukan induksi anestesi umum, variasi pletismograf dicatat sebelum, saat, dan sesudah elevasi tungkai secara pasif. Hasil penelitian menunjukkan efek elevasi tungkai secara pasif akan menurunkan variasi pletismograf. Penurunan variasi pletismograf yang signifikan pada responden yang memiliki responsivitas terhadap cairan 6/30 dengan variasi pletismograf >13% sebelum dilakukan elevasi tungkai secara pasif. Perbedaan ini bermakna secara statistik (p<0,05). Elevasi tungkai secara pasif akan menurunkan variasi pletismograf yang dapat digunakan untuk menilai responsivitas terhadap cairan pada pasien yang menjalani operasi dengan anestesi umum.Kata kunci: Anestesi umum, elevasi tungkai secara pasif, responsivitas terhadap cairan, variasi pletismografEffect of Passive Leg Raising Test on Respiratory Variations in Pulse Oximetry Plethysmographic Waveform in Assessing Fluid Responsiveness of Surgery Patients under General AnesthesiaFluid responsiveness assessments have shown to be an important matter in perioperative fluid optimization. Respiratory variations in pulse oximetry plethysmographic waveform amplitude (∆POP) and passive leg raising have been shown as promising indicators due to the ability to predict fluid responsiveness. The aim of this study was to assess the effect of passive leg raising (PLR) on ∆POP to predict fluid responsiveness in mechanically ventilated patients after induction of general anesthesia. This was a trialon 30 patients referred for surgery under general anesthesia, aged 18–60 years and ASA physical status I or II, during the period of February–March 2015 at the Central Surgical Installation of Dr. Hasan Sadikin General Hospital Bandung. Patients were studied immediately after the induction of general anesthesia. This trial use the paired t test, Wilcoxon test, and ANOVA for statistical analysis. Vital signs and ∆POP were recorded at baseline, before, and after PLR. PLR induced changes in ∆POP with a ∆POP greater than 13% compared to the initial PLR allowed discrimination between responders and nonresponders to 6/30. There was a significant decrease in ∆POP in responders when compared to the nonresponders(p<0.05). ∆POP can be reduced by PLR and fluid responsiveness can be predicted noninvasively in mechanically ventilated patients during general anesthesia.Key words: Fluid responsiveness, general anesthesia, passive leg raising, respiratory variations in the pulse oximetry plethysmographic waveform amplitude DOI: 10.15851/jap.v4n2.821
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