DOI: https://doi.org/10.14710/jai.v8i3.19817

Manajemen Transfusi Perioperatif Pada Pasien Bedah Jantung Dewasa dengan Mesin Pintas Jantung Paru

Departemen Anestesi dan Perawatan Intensif Pasca Bedah RS Pusat Jantung Nasional Harapan Kita, Jakarta, Indonesia

Published: 1 Nov 2016.
Open Access Copyright 2016 (JAI) Jurnal Anestesiologi Indonesia

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Abstract

Transfusi darah umum dilakukan pada pasien bedah jantung, mencakup 10-20% dari total transfusi darah yang diberikan. Diperkirakan 60-70% pemberian transfusi terjadi selama periode perioperatif. Pemintasan jantung paru menggunakan mesin pintas jantung paru/ cardiopulmonary bypass (CPB) machine merupakan teknik penting yang telah digunakan selama lebih dari 60 tahun. Mesin ini membantu dokter bedah jantung mendapatkan area kerja yang tidak bergerak dan bersih. Dalam konteks koagulasi, pemakaian mesin CPB akan mengakibatkan timbulnya anemia hemodilusi akibat priming, sehingga seringkali memerlukan transfusi darah.Beberapa penelitian menunjukkan keterkaitan antara transfusi alogenik terkait dengan peningkatan morbiditas seperti infeksi, cidera ginjal akut, reaksi hemolitik akut, reaksi alergi, cidera paru, kelebihan cairan, dan peningkatan mortalitas.Pemberian transfusi alogenik dapat dikurangi dengan protokol transfusi restriktif, penggunaan metode autotransfusi, pemberian eritropoetin (EPO), antiplatelet, dan antifibrinolitik. Manajemen transfusi yang tepat dan rasional selama periode perioperatif bedah jantung dapat menurunkan mortalitas dan morbiditas secara signifikan.

 

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Keywords: anemia hemodilusi; autotransfusi; mesin pintas jantung paru

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Section: Literature Reviews
Language : ID
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