<![CDATA[Terapi cairan merupakan landasan penting dalam merawat pasien kritis di intensive care unit (ICU), termasuk pasien sepsis. Terapi liberal dan goal-directed dianjurkan untuk mencapai tekanan arteri rata-rata lebih dari 65 mmHg pada tahap awal syok. Meskipun demikian, resusitasi cairan berlebihan meningkatkan tekanan hidrostatik mikrovaskular dan dapat menyebabkan akumulasi cairan interstitial. Resusitasi cairan yang memanjang berhubungan dengan kelebihan cairan dan meningkatkan mortalitas. Penelitian ini bertujuan untuk menilai seberapa besar hubungan antara kelebihan cairan dan angka mortalitas. Melalui studi case control, data dikumpulkan secara retrospektif dari Desember 2013 berdasarkan rekam medik di ICU RSUP Dr. Mohammad Hoesin Palembang sampai jumlah sampel tercukupi. Subjek penelitian adalah pasien sepsis berat dan syok septik yang mendapat resusitasi early goal directed therapy. Enam puluh subjek yang memenuhi kriteria yang dibagi menjadi kelompok survivors dan non-urvivors. Kelompok non survivors ditemukan lebih banyak dengan kelebihan cairan ≥10% (73,3%) dibanding dengan kelebihan cairan <10% (26,7%). Sedangkan pada kelompok survivors ditemukan lebih banyak dengan kelebihan cairan <10% (66,7%) dibanding dengan kelebihan cairan ≥10% (33,3%). Pasien sepsis berat dan syok septik yang memiliki kelebihan cairan ≥10% mempunyai risiko kematian 5,5 kali lebih besar dibanding dengan kelebihan cairan <10%.
Kata kunci: Kelebihan cairan, liberal, mortalitas, pasien sepsis
Observational Analytic Study: Fluid Overload Increases Mortality Rate of Sepsis Patients in Intensive Care Unit (ICU)
Fluid therapy is an important cornerstone of treating critically ill patients in ICU, including sepsis patients. In early stage of shock, liberal and goal-directed therapy is mandated to achive mean arterial pressure over 65 mmHg. Nevertheless, over resuscitation increases microvascular hydrostatic pressure and may promote interstitial fluid accumulation. Prolonged fluid resuscitation has a close relationship to fluid overload and high mortality rate. The aim of this study was to assess the relationship between fluid overload and mortality rate. The data were retrospectively collected using case control study since December 2013 based on medical records in ICU Dr Mohammad Hoesin General Hospital Palembang until the sample sufficient. Subjects included in this study were those who diagnosed as severe sepsis and septic shock who undergone early goal directed therapy for resuscitation. There were sixty subjects included for both survivors and non-survivors group. Non-survivors group have more fluid overload >10% (73,3%) compared with <10% (26.7%). While survivors group have have more fluid overload <10% (66.7%) compared with >10% (33.3%). Severe sepsis and septic shock patients who have fluid overload >10% has risk 5,5 times to death compared with <10%.
Key words: Fluid overload, liberal, mortality, sepsis
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