ABSTRAKLatar Belakang: Sebanyak 86 pasien dengan administrasi cairan mengalami akumulasi cairan positif hingga menyebabkan 35 dari seluruh pasien ICU tahun 2009-2012 mengalami volume cairan berlebih. Efek terburuk akibat hal ini adalah kegagalan multi sistem organ tubuh. Sehingga, salah satu penanganan volume cairan berlebih adalah intervensi diuresis untuk menyelesaikan masalah fisiologis. Masih belum dibuktikan melalui penelitian mengenai manfaat penyelesaian disfungsi sistem organ dari diuresis furosemid untuk menurunkan balans cairan di saat pasien justru mengalami hipoperfusi organ serta berbagai efek samping dari furosemid tersebut.Tujuan: Atas dasar itu, dilakukan penelitian berupa analisis hubungan antara perubahan status disfungsi sistem organ berdasarkan skor MSOFA dengan penggunaan furosemid, beserta analisis data demografik dan klinik pasien volume cairan berlebih di perawatan intensif.Metode: Desain penelitian merupakan kohort retrospektif dengan pengambilan data dari 194 sampel rekam medik yang didapatkan secara consecutive sampling. Data penggunaan furosemid dan perubahan skor MSOFA pada pasien fluid overload dimasukkan dalam tabel 2x2, kemudian dianalisis menggunakan metode chi square. Hasil: Hasil membuktikan bahwa terdapat hubungan signifikan antara perubahan status disfungsi sistem organ dengan penggunaan furosemid pada pasien perawatan intensif p.

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ABSTRACT

Eighty

-

six percent of

patient

s

were

administrated

with IV Fluid

resuscitation

had

positive fluid accumulation that results in fluid overload

i

n

35%

of all ICU patients in 2009

-

2012. The worst consequence of this situation is multi

organs failures. Thus, one of the fluid overload treatment is pharmacological

diuresis to solve the physiological problems. Despite of its adverse effects and fluid

bal

ance decrement on the

hypo

perfusion

organ, the organ failure

re

solution of

furosemide usage has not been proven through any research. Hence, a research

which analyzed the

correlation of organ system failure status based on modified

sequential organ fai

lure assessment score with furosemide usage on intensive care

patient

and their

demographics

data has been conducted.

Method:

The research design was

a

retrospective

cohort which analyzed 194

subjects from

Cipto Mangunkusumo Hospital ICU

medical records selected by

consecutive sampling method. Data of furosemide usage and MSOFA Score

changes were recorded to

the

2x2

table, then they were analyzed by chi square

method.

Results:

The result

pro

ve

s

that

there is significant association

between

worsening

organ system failure with fur

osemide usage on critically ill

pati

ents (p<0,05),

especially in cardiovascular and central venous system.

The relative risk result

s

hows that

furosemide usage resulted in

higher MSOFA score 1,271 times more

than those patients with no furosemide

diuresis usage (95% CI

1,108

-

1,458

).

Conclusions:

The furosemide usage worsens the organ failure based on MSOFA

score.

These can be resulted by

iatrogenic effect of too negative

fluid balance and

furosemide's adverse effects in the patients. There are clinical data which have

significant correlation and can be analysed further, including: fluid balance before

and afte

r therapy, risk factors

, and organ failure components.