DOI: https://doi.org/10.14710/jai.v15i2.53937

Tatalaksana Badai Tiroid dan Aritmia di ICU: Serial Kasus

1Rumah Sakit Panti Wilasa dr. Cipto, Semarang, Indonesia

2Departemen Anestesi, Rumah Sakit Panti Wilasa dr. Cipto, Semarang, Indonesia

Received: 26 Apr 2023; Published: 31 Jul 2023.
Open Access Copyright 2023 JAI (Jurnal Anestesiologi Indonesia)

Citation Format:
Abstract

Latar belakang: Badai tiroid atau krisis hipertiroid merupakan komplikasi hipertiroidisme akut yang mengancam jiwa dan sebagai presentasi dari tirotoksikosis yang berlebihan. Gejala badai tiroid yang paling parah yang mungkin terjadi berupa aritmia atrium dan/atau ventrikel, gagal jantung, dan/atau henti jantung.

Kasus: Pada ketiga kasus, terdapat gambaran klinis serta gangguan irama jantung yang berbeda berupa atrial fibrilasi (AF) dan supraventrikuler takikardi (SVT) yang berhubungan dengan hipertiroidisme. Terdapat kegawatdaruratan badai tiroid yang dapat mengancam nyawa sehingga diperlukan perawatan yang intensif pada ketiga pasien tersebut. Selama perawatan di intensive care unit (ICU), ketiga pasien mendapatkan terapi standar berupa antitiroid dan obat antiaritmia golongan beta bloker dan golongan glikosida digitalis.

Diskusi: Peningkatan hormon tiroid memiliki peran untuk menyebabkan AF dan SVT. Setelah dilakukan tatalaksana sesuai dengan Japan Guideline Thyroid Storm (2016), terdapat perbaikan pada kasus 2 dan 3. Namun, pada kasus 1 tetap didapatkan SVT persisten dengan badai tiroid yang tidak terkontrol.

Kesimpulan: Gambaran klinis badai tiroid bervariasi, mulai dari disfungsi sistem termoregulasi, gangguan gastrointestinal dan hati, gangguan sistem saraf pusat, dan gangguan irama jantung. Pada ketiga kasus ini, gambaran klinis dari hipertiroidisme akut dan badai tiroid berbeda-beda. Namun, terdapat kegawatdaruratan yang sama yang dapat mengancam nyawa sehingga diperlukan perawatan yang intensif pada ketiga pasien tersebut.

Note: This article has supplementary file(s).

Fulltext View|Download |  Copyright Transfer Agreement
Copyright Transfer Agreement Tatalaksana Badai Tiroid
Subject
Type Copyright Transfer Agreement
  Download (1MB)    Indexing metadata
 Research Instrument
Tabel dan Gambar Tatalaksana Badai Tiroid
Subject
Type Research Instrument
  Download (851KB)    Indexing metadata
 Cover Letter
Introduction Pages Tatalaksana Badai Tiroid
Subject
Type Cover Letter
  Download (96KB)    Indexing metadata
Keywords: AF; badai tiroid; perawatan intensif; serial kasus; SVT

Article Metrics:

Article Info
Section: Case Reports
Language : ID
Recent articles
SWOT Analisis Pelayanan Klinik Nyeri Rumah Sakit St. Elisabeth Semarang Epidural Labor Analgesia pada Ibu Hamil dengan Blok Total Atrioventrikuler yang Terinfeksi Coronavisrus Disease–19 (COVID-19) Tatalaksana Badai Tiroid dan Aritmia di ICU: Serial Kasus Covid-19 with Methicillin-Resistant Staphylococcus Aureus: Based on Two Cases in Diponegoro National Hospital More recent articles
Most cited articles
Midazolam Intravena Dosis Rendah Tidak Mempengaruhi Nitric Oxide Intraperitoneal Mencit Balb/C Yang Terpapar Lipopolisakarida Patofisiologi Penyakit Jantung Koroner More cited articles
  1. Rajuddin R, Budiman, Shalahuddin, Taufika DA. Hyperthyroid in pregnancy: A case report. Systematic Reviews in Pharmacy. 2020;11(5):18–20
  2. Pokhrel B, Aiman W, Bhusal K. Thyroid Storm [Internet]. StatPearls. 2023. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27521067
  3. Hall P, Lundell G, Holm LE. Mortality in patients treated for hyperthyroidism with iodine-131. Acta Endocrinol (Copenh) [Internet]. 1993 Mar;128(3):230–4. Available from: https://academic.oup.com/ejendo/article/128/3/230/6769581
  4. Akamizu T, Satoh T, Isozaki O, Suzuki A, Wakino S, Iburi T, et al. Diagnostic Criteria, Clinical Features, and Incidence of Thyroid Storm Based on Nationwide Surveys. Thyroid [Internet]. 2012 Jul;22(7):661–79. Available from: https://www.liebertpub.com/doi/10.1089/thy.2011.0334
  5. Burch HB, Wartofsky L. Life-threatening thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North Am [Internet]. 1993 Jun;22(2):263–77. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8325286
  6. Anjo D, Maia J, Carvalho AC, Castro H, Aragão I, Vieira AP, et al. Thyroid storm and arrhythmic storm: a potentially fatal combination. Am J Emerg Med. 2013 Sep;31(9):1418.e3-1418.e5
  7. Biondi B, Kahaly GJ. Cardiovascular involvement in patients with different causes of hyperthyroidism. Nat Rev Endocrinol. 2010 Aug 29;6(8):431–43
  8. Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343–421
  9. Ertek S, Cicero AF. State of the art paper Hyperthyroidism and cardiovascular complications: a narrative review on the basis of pathophysiology. Archives of Medical Science. 2013;5:944–52
  10. De Almeida R, McCalmon S, Cabandugama PK. Clinical Review and Update on the Management of Thyroid Storm. Mo Med. 2022;119(4):366–71
  11. Snyder S, Joseph M. The Perfect Storm: A Case of Ischemic Stroke in the Setting of Thyroid Storm. Cureus. 2020;12(5)
  12. Chen YC, Chen SA, Chen YJ, Chang MS, Chan P, Lin CI. Effects of thyroid hormone on the arrhythmogenic activity of pulmonary vein cardiomyocytes. J Am Coll Cardiol. 2002 Jan;39(2):366–72
  13. Reddy V, Taha W, Kundumadam S, Khan M. Atrial fibrillation and hyperthyroidism: A literature review. Indian Heart J. 2017 Jul;69(4):545–50
  14. Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of Atrial Fibrillation on the Risk of Death. Circulation. 1998 Sep 8;98(10):946–52
  15. Frost L, Engholm G, Johnsen S, Møller H, Henneberg EW, Husted S. Incident Thromboembolism in the Aorta and the Renal, Mesenteric, Pelvic, and Extremity Arteries After Discharge From the Hospital With a Diagnosis of Atrial Fibrillation. Arch Intern Med. 2001 Jan 22;161(2):272
  16. Frost L, Engholm G, Johnsen S, Møller H, Husted S. Incident stroke after discharge from the hospital with a diagnosis of atrial fibrillation. Am J Med. 2000 Jan;108(1):36–40
  17. Frost L. Decrease in mortality in patients with a hospital diagnosis of atrial fibrillation in Denmark during the period 1980–1993. Eur Heart J. 1999 Nov;20(21):1592–9
  18. Frost L, Vestergaard P, Mosekilde L. Hyperthyroidism and Risk of Atrial Fibrillation or Flutter. Arch Intern Med. 2004 Aug 9;164(15):1675
  19. Hindricks G, Potpara T, Dagres N, Bax JJ, Boriani G, Dan GA, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021;42(5):373–498
  20. Rampengan SH. AMIODARON SEBAGAI OBAT ANTI ARITMIA DAN PENGARUHNYA TERHADAP FUNGSI TIROID. JURNAL BIOMEDIK (JBM). 2013 Feb 6;3(2)
  21. Wantania FE. PENATALAKSANAAN PENYAKIT JANTUNG TIROID. JURNAL BIOMEDIK (JBM). 2014 Apr 2;6(1)
  22. Gwag H Bin, Jun JE, Park Y, Lee SS, Park SJ, Kim JS, et al. Thyroid dysfunction in patients with suspected or documented supraventricular tachyarrhythmia. International Journal of Arrhythmia. 2019 Dec 10;20(1):6
  23. Satoh T, Isozaki O, Suzuki A, Wakino S, Iburi T, Tsuboi K, et al. 2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition). Endocr J. 2016;63(12):1025–64

Last update:

No citation recorded.

Last update: 2024-12-18 02:18:21

No citation recorded.