Hubungan Volume Cairan dengan Cardiac Output dan Venous Return pada Pasien Kritis
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Pemberian cairan merupakan salah satu intervensi medis yang sering dilakukan pada pasien kritis di intensif care unit (ICU). Perkembangan ilmu mengenai cairan tubuh dulu lebih menitikberatkan pada fisiologi jantung kiri. Cardiac output, pada mulanya lebih dikenal sebagai fungsi jantung kiri dimana cardiac output ditentukan oleh jumlah darah yang dipompa dari ventrikel kiri dalam semenit (stroke volume) dan heart rate. Namun demikian, ternyata pemahaman fisiologi kardiovaskular tidak sesederhana itu. Menurut Starling, jantung hanya akan memompa darah yang masuk ke dalam jantung kanan. Dengan demikian, jumlah darah yang masuk ke jantung kanan harus sama dengan jumlah darah yang dipompa oleh jantung kiri, dimana keduanya adalah cardiac output. Ini kemudian diteliti lagi oleh Guyton. Guyton mencoba memandang cardiac output sebagai darah yang masuk ke jantung kanan (venous return). Terdapat banyak faktor yang menentukan kembalinya cairan ke jantung kanan. Faktor perbedaan tekanan antara mean systemic filling pressure (MSFP) dengan tekanan atrium kanan, serta faktor resistensi vena merupakan faktor penentu dalam fungsi venous return. Guyton juga mencari hubungan antara fungsi jantung dengan fungsi venous return. Pemahaman cardiac output secara utuh baik sebagai fungsi jantung dan sebagai venous return ini dapat menjelaskan banyak hal yang berhubungan dengan disfungsi kardiovaskular maupun gangguan ekstra kardiak pada pasien kritis dengan kondisi syok. Oleh karena itu, sangat penting bagi klinisi untuk memahami hubungan antara cairan tubuh dengan cardiac output dan venous return.
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Last update: 2021-03-02 13:26:48
Last update: 2021-03-02 13:26:49
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