Penggunaan Heparin Dosis Tinggi pada Pasien COVID-19 dengan ARDS dan Hipertensi di Unit Perawatan Intensif (ICU)

*Taufik Eko Nugroho  -  Department of Anesthesiology and Intensive Theraphy; Faculty of Medicine; Diponegoro University; Semarang, Indonesia
Mochamat Mochamat scopus  -  Department of Anesthesiology and Intensive Theraphy; Faculty of Medicine; Diponegoro University; Semarang, Indonesia
Famila Famila  -  Department of Anesthesiology and Intensive Theraphy; Faculty of Medicine; Diponegoro University; Semarang, Indonesia
Published: 1 Nov 2020.
Open Access
Citation Format:
Abstract

Latar Belakang: Corona Virus Disease 2019 (COVID-19), pertama kali dilaporkan pada bulan Desember 2019 di Cina, merupakan penyakit yang disebabkan oleh virus SARS-CoV-2 yang menyebar lebih cepat pada populasi manusia dan dalam waktu singkat berkembang menjadi pandemi di seluruh dunia. Sebagian besar kasus yang berujung pada kematian dilaporkan terkomplikasi dengan koagulopati dan disseminated intravascular cogulation (DIC).

Kasus: Seorang laki-laki terkonfirmasi positif COVID-19 berusia 50 tahun dengan sesak, batuk dan demam dan komorbiditas hipertensi dirujuk ke intensive care unit (ICU), selama di ICU pasien mendapat terapi heparin dengan dosis terapi dengan melihat kadar aPTT. Setelah perawatan intensif selama 14 hari, pasien mengalami perbaikan yang signifikan.

Pembahasan: Pasien dengan infeksi COVID-19 yang progresif dan parah dengan acute respiratory distress syndrome (ARDS) seringkali ditemukan dengan kadar D-dimer dan fibrinogen yang sangat tinggi, yang berujung pada keadaan hiperkoagulasi. Penggunaan antikoagulan untuk pasien dengan COVID-19 yang parah telah. Banyak institusi telah menerapkan penggunaan antikoagulan dosis penuh secara empiris berdasarkan risiko venous thrombo embolism (VTE) dan insiden rendah perdarahan (3-5%).

Kesimpulan: Penggunaan antikoagulan, khususnya unfractionatedheparin (UFH) dengan dosis lebih tinggi, direkomendasikan untuk pasien dengan COVID-19 yang parah, meskipun belum ada panduan yang mutlak.

 

Keywords: ARDS; COVID-19; heparin; koagulopati; VTE

Article Metrics:

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Last update: 2021-03-07 13:31:56

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