skip to main content

Analisis Terhadap Faktor Risiko yang Berhubungan dengan Mortalitas Pasien Sindrom Guillain-Barré yang Dilakukan Plasmaferesis

1Fakultas Kedokteran, Universitas Padjajaran, Bandung, Indonesia

2Departemen Anestesi dan Terapi Intensif, Fakultas Kedokteran, Universitas Padjadjaran/RSUP dr. Hasan Sadikin Bandung, Indonesia

Received: 1 Aug 2023; Revised: 20 Oct 2023; Accepted: 31 Oct 2023; Available online: 30 Nov 2023; Published: 20 Nov 2023.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)

Citation Format:
Cover Image
Abstract

Latar Belakang: Sindrom Guillain-Barré (SGB) merupakan penyakit autoimun yang mengenai sistem saraf tepi yang banyak ditemukan di dunia. Penyakit ini memiliki manifestasi berupa kelemahan, arefleksia otot secara progresif dan dapat menyebabkan kelemahan pada otot-otot pernapasan. Hal ini menyebabkan penderita membutuhkan bantuan ventilasi mekanik. American Society for Apheresis (ASFA) menyatakan pengobatan lini pertama krisis sindrom Guillain-Barré (SGB) fase akut adalah dengan pemberian therapeutic plasma exchange/plasmaferesis. Therapeutic plasma exchange merupakan prosedur yang relatif aman dan sudah sering dilakukan di unit rawat intensif Rumah Sakit Hasan Sadikin (RSHS) Bandung.

Tujuan: Penelitian ini dilakukan untuk menganalisis faktor-faktor risiko yang berhubungan dengan mortalitas pasien SGB yang telah menjalani terapi plasmaferesis.

Metode: Penelitian ini merupakan penelitian analitik multivariat dengan desain kasus kontrol yang dilakukan pada 55 sampel pasien SGB yang mendapatkan terapi plasmaferesis di unit rawat intensif RSHS Bandung dan rumah sakit (RS) Bhayangkara Tingkat II Medan. Penelitian ini bersifat retrospektif dengan mengambil data dari rekam medis serta menyajikan karakteristik dasar subjek.

Hasil: Penelitian ini mendapatkan hasil bahwa diantara faktor-faktor risiko yaitu usia, komorbid, dan lama penggunaan ventilasi mekanik, yang paling berhubungan dengan mortalitas pasien SGB yang telah menjalani terapi plasmaferesis adalah faktor lamanya penggunaan ventilasi mekanik >14 hari.

Kesimpulan: Faktor risiko penggunaan mesin ventilasi mekanik berkepanjangan (>14 hari) berhubungan dengan tingginya kejadian mortalitas/kematian pada pasien SGB yang menjalani terapi di RSHS Bandung, maupun di RS Bhayangkara Tingkat II Medan.

Note: This article has supplementary file(s).

Fulltext View|Download |  Research Instrument
Ethical Clearance
Subject
Type Research Instrument
  Download (81KB)    Indexing metadata
 Copyright Transfer Agreement
Copyright Transfer Agreement
Subject
Type Copyright Transfer Agreement
  Download (23KB)    Indexing metadata
 Research Results
Tabel Hasil Penelitian
Subject
Type Research Results
  Download (21KB)    Indexing metadata
Keywords: faktor risiko; mortalitas; plasmaferesis; sindrom Guillain-Barré (SGB); ventilasi mekanik berkepanjangan

Article Metrics:

  1. Esposito S, Longo MR. Guillain–Barré syndrome. Autoimmun Rev 2017;16: 96–101. https://doi.org/10.1016/j.autrev.2016.09.022
  2. Wijdicks EFM, Klein CJ. Guillain-Barré Syndrome. Mayo Clin Proc 2017;92: 467–479 https://doi.org/10.1016/j.mayocp.2016.12.002
  3. Berg B Van Den, Bunschoten C, Doorn PA Van. Mortality in Guillain- Barré syndrome. Am Acad Neurol 2013; 1650–1654 https://doi.org/10.1212/wnl.0b013e3182904fcc
  4. Nguyen TP, Taylor. RS. Guillain Barre Syndrome. StatPearls- NCBI Bookshelf, https://www.ncbi.nlm.nih.gov/books/NBK532254/ (2022, accessed 4 September 2022)
  5. Shahrizaila N, Lehmann HC, Kuwabara S., Guillain-Barré syndrome. Lancet 2021; 397: 1214–1228 https://doi.org/10.1016/s0140-6736(21)00517-1
  6. Shang P, Feng J, Wu W, Zhang HL. Intensive Care and Treatment of Severe Guillain–Barré Syndrome. Front Pharmacol 2021; 12: 1–17 https://doi.org/10.3389/fphar.2021.608130
  7. Wen P, Wang L, Liu H, Gong L, Ji H, Wu H, et al. Risk factors for the severity of Guillain-Barré syndrome and predictors of short-term prognosis of severe Guillain-Barré syndrome. Sci Rep 2021; 11: 1–9 https://doi.org/10.1038/s41598-021-91132-3
  8. Liou LS, Chung CH, Wu YT, Tsao CH, Wu YF, Chien WC, et al. Epidemiology and prognostic factors of inpatient mortality of Guillain-Barré syndrome: A nationwide population study over 14 years in Asian country. J Neurol Sci 2016; 369: 159–164 https://doi.org/10.1016/j.jns.2016.08.014
  9. Ishaque T, Islam MB, Ara G, Endtz HP, Mohamad QD, Jacobs BC, et al. High mortality from Guillain-Barré syndrome in Bangladesh. J Peripher Nerv Syst 2017; 22: 121–126 https://doi.org/10.1111/jns.12215
  10. Hosseininezhad M, Khatami SS, Saadat S, Asghari M, Choshal HG, Marvasti AH, et al. Ten years evaluation of epidemiology- and mortality-related factors in adults and children with Guillain-Barré syndrome in the north of Iran. Neurol Sci 2022; 43: 1929–1938 https://doi.org/10.1007/s10072-021-05562-y
  11. Roman-Filip C, Catană MG, Bereanu A, Lăzăroae A, Gligor F, Sava M. Therapeutic Plasma Exchange and Double Filtration Plasmapheresis in Severe Neuroimmune Disorders. Acta Clin Croat 2019; 58: 621–626 https://doi.org/10.20471/acc.2019.58.04.08
  12. Calca R, Gaspar A, Santos A, Aufico A, Freitas P, Coelho S. Therapeutic plasma exchange in patients in a Portuguese ICU. Port J Nephrol Hypertens. 2020;34(1):21-5 https://doi.org/10.32932/pjnh.2020.04.058
  13. Brunetta Gavranić B, Bašić-Jukić N, Premužić V, Kes P. Membrane therapeutic plasma exchange with and without heparin anticoagulation. J Clin Apher 2017; 32: 479–485 https://doi.org/10.1002/jca.21544
  14. Ruiz DD, San Miguel FF, González de Molina FJ, Úbeda- Iglesias A, Pérez AN, Jannone Forés R. Plasmapheresis and other extracorporeal filtration techniques in critical patients. Med Intensiva.2017;41(3):174–87 https://doi.org/10.1016/j.medin.2016.10.005
  15. Lemaire A, Parquet N, Galicier L, Boutboul D, Bertinchamp R, Malphettes M, et al. Plasma exchange in the intensive care unit: Technical aspects and complications. J Clin Apher. 2017;32(6):405–12 https://doi.org/10.1002/jca.21529
  16. Maskoen, T. T., Inggriani, A. A., & Erlangga, M. E. Characteristics of Therapeutic Plasma Exchange Procedures in Patients with Myasthenia Gravis and Guillain Barre Syndrome and their Outcomes during Hospitalization in General Intensive Care Unit Hasan Sadikin General Hospital Bandung in January 2017 to December 2020. Journal of Health and Medical Sciences, 2022;4, 45-54. doi: 10.31014/aior.1994.05.04.245
  17. Sharma, G., Sood, S. and Sharma, S. Seasonal, Age & Gender Variation of Guillain Barre Syndrome in a Tertiary Referral Center in India. Neuroscience and Medicine, 2013;4, 23-28. doi: 10.4236/nm.2013.41004
  18. Netto AB, Taly AB, Kulkarni GB, Rao UG, Rao S. Mortality in mechanically ventilated patients of Guillain Barré Syndrome. 2011; 14: 2–6 https://doi.org/10.4103/0972-2327.91942
  19. Sipilä, J. O. T., Soilu-Hänninen, M., Ruuskanen, J. O., Rautava, P., & Kytö, V. Epidemiology of Guillain-Barré syndrome in Finland 2004-2014. Journal of the peripheral nervous system: JPNS, 2017;22(4), 440–445. https://doi.org/10.1111/jns.12239
  20. Pei Zheng, De-Cai Tian, Yuwen Xiu, Yongjun Wang, Fu-Dong Shi. Incidence of Guillain-Barrè syndrome (GBS) in China: A national population-based study, The Lancet Regional Health-Western Pacific. Volume18. 2022. ISSN 2666/6065. https://doi.org/10.1016/j.lanwpc.2021.100302
  21. Winer JB. An update in Gullian-Barre syndrome. Autoimmune Dis. 2014;1-6 https://doi.org/10.1155/2014/793024
  22. Hagen, K. M., & Ousman, S. S. The Neuroimmunology of Guillain-Barré Syndrome and the Potential Role of an Aging Immune System. Frontiers in aging neuroscience, 2021;12, 613628. https://doi.org/10.3389/fnagi.2020.613628
  23. Siddiqui S, Khan F. APACHE-II score correlation with mortality and length of stay in an Intensive Care Unit. Journal of the College of Physicians and Surgeons Pakistan. 2011; 21(1), 4-8 https://doi.org/10.1378/chest.130.4_meetingabstracts.222s-c
  24. Ou SM, Liu CJ, Chang YS, Hu YW, Chao PW, Chen TJ, et al Tuberculosis in Guillain-Barré Syndrome. Int J Tuberc Lung Dis. 2013;17(1):79–84 https://doi.org/10.5588/ijtld.12.0260
  25. Stojanov A, Berisavac I, Bozovic I, Arsenijevic M, Rajic SL, Petrovic M. et al. Incidence and mortality rates of Guillain-Barré syndrome in Serbia. J Peripher Nerv Syst. 2020;1–6 https://doi.org/10.1111/jns.12412
  26. Portugal Rodríguez E, Berrazueta Sánchez de Vega A, Vara Arlanzón R, Martínez Barrio E, Del Valle Ortiz M, Fernández Ratero J, et al. Predisposing factors, neurological complicationsand sequels of guillain barre syndrome at discharge: experience in an ICU of a third level hospital. Intensive Care Med Exp. 2015;3(1):1–2 https://doi.org/10.1186/2197-425x-3-s1-a993
  27. Van den berg B, Bunschoten C, van Doorn PA, Jacobs BC. Mortality in Guillain-Barré syndrome. Neurology. 2013;80(18):1650-1654. doi: 10.1212/WNL.0b013e3182904fcc

Last update:

No citation recorded.

Last update: 2024-11-05 18:07:34

No citation recorded.