Efek Pemberian Midazolam atau Propofol Terhadap Lama Penggunaan Ventilator Mekanik di ICU RSUP Dr. Kariadi
Pendahuluan : Sedasi di ruang intensif dapat memperbaiki outcome perawatan dan
membuat pasien lebih nyaman, namun juga berpotensi memperpanjang durasi ventilasi
mekanik dan length of stay (LOS). Obat yang saat ini sering digunakan adalah
midazolam, namun durasi kerja midazolam dapat memanjang pada pasien dengan gagal
fungsi organ. Propofol adalah obat sedasi dengan klirens tinggi dan tanpa metabolit aktif
yang dapat digunakan untuk memperpendek durasi ventilasi mekanik dan LOS pasien.
Membandingkan durasi ventilasi mekanik dan biaya sedasi pada pasien pascabedah di
ruang intensif yang disedasi menggunakan midazolam dan propofol.
Metode : Dilakukan penelitian obser vasional dengan desain cross-sectional terhadap
30 pasien pascabedah dengan ventilator di ICU yang dibagi menjadi 2 kelompok secara
acak, masing-masing kelompok terdiri dari 15 pasien. Kelompok I mendapat midazolam
bolus 0,02-0,08 mg/kg IV, dilanjutkan infus kontinyu dosis 0,04-0,2 mg/kg/jam.
Kelompok II mendapat Propofol bolus 1,5-2,5 mg/kg IV, dilanjutkan infus kontinyu dosis
5-80 μg/kg/menit. Target skor RASS adalah -1 sampai -2, yang dipantau 1 jam
pascasedasi, dilanjutkan tiap 4 jam setelahnya. Pencatatan dilakukan terhadap durasi
ventilator mekanik, rerata skor RASS, dan biaya sedasi.
Hasil : Penelitian ini menunjukan bahwa dur asi ventilasi mekanik dan biaya sedasi
pada kelompok propofol lebih rendah daripada midazolam, namun perbedaannya tidak
bermakna dengan nilai p≤0,05.
Kesimpulan : Sedasi pasien pascabedah dengan ventilator di r uang intensif dengan
propofol lebih efektif dalam mengurangi durasi ventilasi mekanik dan biaya sedasi
daripada midazolam, namun tidak berbeda bermakna.
Other format:
Article Metrics:
- Payen JF, Chanques G, Mantz J, Hercule C, Auriant I, Lequillou JL, et al. Current practices in sedation and analgesia for mechanically ventilated critically ill patients: a prospective multicenter patient-based study. Anesthesiology [Internet]. 2007 [cited 2017 Apr 13]; 106(4): 687-95. Available from: https://www.ncbi.nlm.nih.gov/pubmed/17413906
- Chatila WM, Criner GJ. Complications of long-term mechanical ventilation. Respir Care CLin N Am [Internet]. 2002 [cited 2017 Sep 2];8(4):631-47. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12602419
- Putra IM. Rerata waktu penggunaan ventilator pada pasien surgical ICU RS dr. kariadi semarang pada bulan januari 2010-januari 2011 [dissertation]. Semarang (Indonesia): Universitas Diponegoro; 2011
- Devlin JW, Roberts RJ. Pharmacology of commonly used analgesics and sedatives in the ICU: benzodiazepines, propofol, and opioids. Anesthesiol Clin [Internet]. 2011 [cited 2017 Apr 13]; 29(4): 567-85. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22078910
- Gommers D, Bakker J. Medications for analgesia and sedation in the intensive care unit: an overview. Crit Care [Internet]. 2008 [cited 2017 May 02]; 12(Suppl 3): S4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2391270/
- Cox CE, Reed SD, Govert JA, Rodgers JE, Bright SC, Kress JP, et al. En economic evaluation of propofol and lorazepam for critically ill patients undergoing mechanical ventilation. Crit Care Med [Internet]. 2008 [cited 2017 Apr 5]; 36(3):706-14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763279/
- Barr J, Fraser GL, Puntillo K, Ely EW, Gelinas C, Dasta JF, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med [Internet]. 2013 [cited 2017 Apr 20]; 41(1): 263-306. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23269131
- Rowe K, Fletcher S. Sedation in the intensive care unit. Continuing Education in Anaesthesia Critical Care & Pain [Internet]. 2008 [cited 2017 Apr 28]; 8(2):50-5. Available from: https://academic.oup.com/bjaed/article/8/2/50/338650/Sedation-in-the-intensive-care-unit
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