Efek pemberian Manitol terhadap penurunan kadar Hematokrit pada kasus peningkatan tekanan Intrakranial pasca cedera kepala : penelitian pendahuluan = The effect of Mannitol administration on Hematocrit level in cases of increased Intracranial pressure post traumatic brain injury : a preliminary study / Yuyun Miftahul Rahma
Yuyun Miftahul Rahma;
Mursyid Bustami, supervisor; Syaiful Ichwan, supervisor; Joedo Prihartono, supervisor; Lyna Soertidewi, examiner; Sitorus, Freddy, examiner; Purba, Jan S., examiner
(Fakultas Kedokteran Universitas Indonesia, 2012)
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ABSTRAK Latar Belakang. Efek penurunan kadar hematokrit oleh manitol memberimanfaat lebih pada tata laksana cedera kepala. Kadar hematokrit 30-35%merupakan kadar hematokrit efektif untuk mendapatkan keluaran yang baik pascacedera kepala. Meski dosis awal rekomendasi pemberian manitol memilikirentang yang cukup besar antara dosis rendah dengan dosis tingginya, kedua dosisini memiliki efektivitas yang sama dalam menurunkan Tekanan Intrakranial(TIK). Diduga kedua dosis ini juga memiliki efek yang sama terhadap penurunankadar hematokrit.Metode. Penelitian ini merupakan uji eksperimental klinis dengan randomizedcontrolled trial tersamarkan. Subjek penelitian adalah pasien cedera kepalasedang (CKS) dan cedera kepala berat (CKB) dengan gejala dan tanda klinispeningkatan TIK yang terindikasi mendapat terapi manitol yang datang ke RumahSakit Cipto Mangunkusumo (RSCM) Jakarta dan bersedia mengikuti penelitian.Dilakukan wawancara, pemeriksaan fisik umum dan neurologis serta pemeriksaankadar hematokrit. Dilakukan analisis data menggunakan perangkat SPSS 17.0.Hasil. Diperoleh 30 subjek pasien cedera kepala sedang dan berat yang mendapatterapi manitol, masing-masing 15 orang untuk kelompok manitol dosis 0.5g /kgBB dan 1g/ kgBB. Terjadi penurunan kadar hematokrit sebesar 5% padakelompok dosis 0.5g/ kgBB dan sebesar 6% pada kelompok manitol dosis 1g/kgBB pasca 10 menit pemberian manitol. Kadar tersebut meningkat kembali kekadar normal 6 jam pasca pemberian. Didapatkan kecendrungan penurunan ratarataMean Arterial Blood Pressure (MABP) dan frekuensi nadi pasca 10 menitpemberian manitol, yang kemudian mengalami peningkatan nilai saat dilakukanpengukuran 6 pasca jam pemberian. Didapatkan kecendrungan peningkatan GCSdan perbaikan reaktivitas pupil pada kedua kelompok dosis manitol di dua waktupengukuran.Kesimpulan. Terdapat kecenderungan penurunan kadar hematokrit pasca 10menit pemberian manitol, yang meningkat kembali ke kadar normal 6 jam pascapemberian pada kedua dosis manitol yang diteliti. Pada penelitian ini jugadidapatkan kecendrungan perbaikan kondisi klinis pasien yang tidak berbeda padakedua dosis manitol pasca 10 menit dan 6 jam pemberian. ABSTRACT Background: The decreasing effect of hematocrit due to mannitol givesadditional benefit in management of traumatic brain injury (TBI). Hematocritlevel of 30 - 35% is the effective level to obtain good outcome after TBI. Eventhough initial recommended dosage of mannitol has a relatively wide rangebetween low and high dosage, both dosages have similar effectivity in reducingintracranial pressure (ICP). It is assumed that both dosages also have similareffect on decreasing hematocrit level.Methods: This was a clinical experimental study with double-blind randomizedcontrolled trial. The study subjects were patients with moderate and severe TBIwith signs and symptoms of increased ICP who have indications to be givenmannitol and were hospitalized in Cipto Mangunkusumo Hospital, Jakarta andagree to participate in the study. All subjects were interviewed, underwent generaland neurological physical examination, as well as level of hematocrit. Dataanalysis were done by using SPSS 17.0.Results: There were 30 patients with moderate and severe TBI who receivedmannitol. They were divided into two groups, each consists of 15 patients. Thefirst group received mannitol 0.5g/kgBW and the second group received 1g/kgBW. Hematocrit level was decreased by 5% in the first group, and 6% in thesecond group after 10 minutes administration of mannitol. The hematocrit levelwas observed to increase to its normal value after 6 hours administration ofmannitol. There was a tendency of decreasing Mean Arterial Blood Pressure(MABP) and heart rate after 10 minutes administration of mannitol, which thenwould increased after 6 hours after administration. In addition, there were alsotendencies of increasing GCS and better pupillary reactivity in both groups onboth measurement.Conclusions: The hematocrit level was found to decrease after 10 minutesadministration of mannitol, and increase back to its normal value after 6 hoursadministration on both dosages. This study also found that moderate and severeTBI patients receiving mannitol tend to show clinical improvement which weresimilar on both dosages both after 10 minutes and 6 hours of adminstration. |
 T-Yuyun Miftaqul Rahmah.pdf :: Unduh
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| No. Panggil : | T-Pdf |
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| Penerbitan : | [Place of publication not identified]: Fakultas Kedokteran Universitas Indonesia, 2012 |
| Program Studi : |
| Bahasa : | ind |
| Sumber Pengatalogan : | LibUI ind rda |
| Tipe Konten : | text |
| Tipe Media : | unmediated ; computer |
| Tipe Carrier : | volume ; online resource |
| Deskripsi Fisik : | xv, 37 pages : illustration ; 28 cm + appendix |
| Naskah Ringkas : | |
| Lembaga Pemilik : | Universitas Indonesia |
| Lokasi : | Perpustakaan UI, Lantai 3 |
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| T-Pdf | TERSEDIA |
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