DOI: https://doi.org/10.14710/jai.v0i0.76588

Management of Continuous Renal Replacement Therapy Following Coronary Artery Bypass Grafting in Intensive Care Unit

Departemen Anestesi dan Terapi Intensif, FKKMK UGM- RS Kemenkes Sardjito, Jl Kesehatan No 1, Sendowo, Sinduadi Mlati Sleman, Indonesia

Received: 30 Jul 2025; Revised: 27 Oct 2025; Accepted: 11 Dec 2025; Available online: 15 Dec 2025.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

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Abstract

Latar Belakang: Cedera Ginjal Akut (AKI) pascaoperasi jantung merupakan komplikasi serius dengan angka kejadian yang tinggi, sehingga meningkatkan morbiditas dan mortalitas. Terapi Penggantian Ginjal Berkelanjutan (TRRT) merupakan metode yang dipilih untuk menggantikan fungsi ginjal pada pasien dengan ketidakstabilan hemodinamik, terutama selama periode kritis pascaoperasi di unit perawatan intensif.

Kasus: Seorang pria berusia 76 tahun dengan riwayat penyakit jantung iskemik dan gagal jantung kronis menjalani operasi bypass arteri koroner (CABG) tanpa pompa. Pasien memiliki komorbiditas termasuk obesitas, apnea tidur obstruktif (OSA), penyakit paru obstruktif kronik (PPOK), pneumonia, dan penyakit ginjal kronik (PGK). Selama perawatan intensif pascaoperasi, pasien mengalami penurunan progresif produksi urin, peningkatan kadar ureum dan kreatinin, serta kelebihan cairan yang signifikan. CRRT dengan mode CVVHDF dimulai pada hari pertama masuk ICU, dan perbaikan klinis diamati setelah empat hari terapi.

Diskusi: Pasien dengan beberapa komorbiditas sering mengalami penurunan fungsi ginjal setelah operasi, sehingga memerlukan intervensi segera. Peran penting CRRT dalam menstabilkan keseimbangan cairan dan metabolisme, sekaligus menjaga stabilitas hemodinamik, tidak dapat dilebih-lebihkan. Pemantauan yang cermat terhadap status volume, hemodinamik, dan hasil laboratorium sangat penting untuk menentukan durasi terapi dan mengevaluasi efektivitasnya.

Kesimpulan : CRRT merupakan terapi yang efektif untuk pasien pasca CABG dengan AKI dan ketidakstabilan hemodinamik. Pendekatan berbasis tim dan pemantauan yang tepat sangat penting untuk keberhasilan terapi dan pemulihan pasien.

Kata Kunci: Terapi Penggantian Ginjal Berkelanjutan, Cedera Ginjal Akut, Cangkok Bypass Arteri Koroner, Unit Perawatan Intensif, Hemodinamik

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Management of Continuous Renal Replacement Therapy Following Coronary Artery Bypass Grafting in Intensive Care Unit
Subject Continuous Renal Replacement Therapy, Acute Kidney Injury, Coronary Artery Bypass Grafting, Intensive Care Unit, Hemodynamics
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Keywords: Continuous Renal Replacement Therapy, Acute Kidney Injury, Coronary Artery Bypass Grafting, Intensive Care Unit, Hemodynamics
Funding: Universitas Gadjah Mada

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Section: Case Reports
Language : EN
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