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Diameter dan Indeks Inferior Vena Cava (IVC) Berkorelasi dengan Central Venous Pressure (CVP) pada Pasien Kritis yang Menggunakan Ventilasi Mekanik di Intensive Care Unit (ICU)

*Buyung Hartiyo Laksono scopus  -  Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Brawijaya- RSUD Dr. Saiful Anwar, Malang, Indonesia
Arie Zainul Fatoni  -  Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Brawijaya- RSUD Dr. Saiful Anwar, Malang, Indonesia
Vilda Prasastri Yuwono  -  Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Brawijaya- RSUD Dr. Saiful Anwar, Malang, Indonesia
Aswoco Andyk Asmoro  -  Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Brawijaya- RSUD Dr. Saiful Anwar, Malang, Indonesia

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Abstract

Latar belakang: Pengukuran central venous pressure (CVP) merupakan salah satu metode guiding deresusitasi pada pasien dengan kasus tertentu. Kenaikan nilai CVP 1 mmHg dikaitkan dengan peningkatan angka kejadian acute kidney injury (AKI). Namun sebagai sebuah metode yang invasif, pemasangan CVP memiliki risiko yang perlu diperhatikan. Di sisilain, pengukuran diameter dan indeks IVC yang bermuara di atrium kanan dengan menggunakan ultrasonografi (USG) non-invasif dinilai mampu untuk memprediksi nilai CVP pada pasien. Namun beberapa penelitian hubungan antara CVP dengan diameter dan indeks IVC memberikan hasil yang kontroversial.

Tujuan: Penelitian untuk mengetahui hubungan antara nilai CVP dengan diameter dan indeks IVC.

Metode: Penelitian ini menggunakan metode cross-sectional pada 30 pasien yang dilakukan ventilasi mekanik dan pemasangan CVC di unit perawatan intensif. Parameter CVP, diameter minimum dan maksimum inferior vein cava (IVC mak, IVC min), distensibillity index (DI-index), dan aortacaval index (Cava/Ao index) diukur. Data dianalisis menggunakan uji korelasi pada SPPS 18.0 (p<0.05).

Hasil: Didapatkan korelasi signifikan antara CVP dan semua variabel yang diuji (IVC mak, IVC min, DI-index, dan Cava/Ao index) (p<0.05), dengan korelasi terkuat antara CVP dan IVC min (R= 0,908). Korelasi bersifat positif, kecuali antara DI-index dan CVP.

Kesimpulan: Parameter IVC min, IVC mak, Cava/Ao- index, dan DI-index signifikan berkorelasi kuat dengan CVP. Korelasi terjadi bersifat positif, kecuali antara DI-index dan CVP.

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Keywords: cava/aorta index; central venous pressure; distensibility index; inferior vena cava; ultrasound

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