[Latar belakang. Kejadian demam pascabedah jantung sering ditemukan akibat tindakan
pembedahan maupun penggunaan mesin pintas jantung paru (PJP), demam tersebut sulit
dibedakan antara demam akibat infeksi atau inflamasi. Penegakan diagnosa infeksi
dengan pemeriksaan kultur membutuhkan waktu lama dan kadang tidak tumbuh bakteri.
Prokalsitonin (PCT) diharapkan sebagai penanda infeksi tanpa harus menunggu hasil
kultur.
Tujuan. Penelitian ini bertujuan menilai kadar PCT dapat membedakan demam infeksi
dengan demam inflamasi pada pascabedah jantung
Metode. Penelitian ini dikerjakan di Unit Pelayanan Jantung Terpadu RSCM, dengan
subyek pasien dewasa pascabedah jantung terbuka dengan menggunakan mesin PJP
diikuti selama lima hari adanya demam dengan suhu ≥ 37,8° C, tanda dan gejala infeksi.
Semua subyek diperiksa PCT dan kultur darah sebelum pembedahan, hari pertama,
kedua dan kelima pascabedah. Pemeriksaan kultur dikerjakan atas indikasi klinis adanya
infeksi.
Hasil. Sebanyak 59 subyek pascabedah jantung menggunakan mesin PJP, terdapat dua
subyek dropout (meninggal pada hari pertama dan kedua), 22 (37,28%) tidak demam, 32
(54,24%) demam inflamasi dan 5 (8,48%) demam infeksi. Infeksi ditemukan dari kultur
sputum (Klebsiella pneumonie), hasil kultur darah, luka operasi, dan urin tidak
ditemukan pertumbuhan bakteri. Didapatkan kadar PCT demam infeksi 13,48 ng/ ml dan
demam inflamasi 6,90 ng/ ml.
Simpulan. Kadar PCT demam infeksi (13,48 ng/ ml) lebih tinggi daripada demam
inflamasi (6,90 ng/ ml). Tidak ada beda kadar PCT demam infeksi dan demam inflamasi
secara statistik dengan p adalah 0,371., Background Post cardiac surgery fevers usually caused by surgery itself or
cardiopulmonary bypass (CPB). Difficulties to differentiated fever caused infection or
inflammation. Bacterial culture to prove infections take a long time and sometimes the
result is negative. Procalcitonin is sugested infection marker without wait for culture.
Goal.The aim of this study is to know procalcitonin level can differentiate fever cause
infectious or inflammation.
Methods. This study performed at Integrated Cardiovascular Unit in RSCM, on adult
patients who had open cardiac surgery with CPB, observed for temperature ≥ 37,8° C,
sign and symptoms of infections, for 5 days. PCT levels and blood culture performed
before surgery, first, second and 5th day after surgery. Culture from other sites performed
as indicated.
Results. There are 59 have cardiac surgery with CPB, There are two subject dropout
(died on 1st and 2nd days), 22 had no fever (37,28%), 32 had inflammation fever
(54,24%) and 5 had infectious fever (8,48%). Infection confirmed by bronchial wash
culture (Klebsiella pneumonie), no surgical wound infection, blood and urine culture
were negative. We have PCT levels infectious group 13,48 ng/ ml and inflammation
group 6,90 ng/ ml.
Conclussion. PCT levels infectious group (13,48 ng/ ml) higher than inflammation
group (6,90 ng/ ml). Non parametric diagnostic Mann Whitney U test there are no
significant differences of PCT levels between infectious and inflammation group,
p=0,371.]
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