[Latar belakang. Kejadian demam pascabedah jantung sering ditemukan akibat tindakanpembedahan maupun penggunaan mesin pintas jantung paru (PJP), demam tersebut sulitdibedakan antara demam akibat infeksi atau inflamasi. Penegakan diagnosa infeksidengan pemeriksaan kultur membutuhkan waktu lama dan kadang tidak tumbuh bakteri.Prokalsitonin (PCT) diharapkan sebagai penanda infeksi tanpa harus menunggu hasilkultur.Tujuan. Penelitian ini bertujuan menilai kadar PCT dapat membedakan demam infeksidengan demam inflamasi pada pascabedah jantungMetode. Penelitian ini dikerjakan di Unit Pelayanan Jantung Terpadu RSCM, dengansubyek pasien dewasa pascabedah jantung terbuka dengan menggunakan mesin PJPdiikuti 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 adanyainfeksi.Hasil. Sebanyak 59 subyek pascabedah jantung menggunakan mesin PJP, terdapat duasubyek 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 kultursputum (Klebsiella pneumonie), hasil kultur darah, luka operasi, dan urin tidakditemukan pertumbuhan bakteri. Didapatkan kadar PCT demam infeksi 13,48 ng/ ml dandemam inflamasi 6,90 ng/ ml.Simpulan. Kadar PCT demam infeksi (13,48 ng/ ml) lebih tinggi daripada demaminflamasi (6,90 ng/ ml). Tidak ada beda kadar PCT demam infeksi dan demam inflamasisecara statistik dengan p adalah 0,371., Background Post cardiac surgery fevers usually caused by surgery itself orcardiopulmonary bypass (CPB). Difficulties to differentiated fever caused infection orinflammation. Bacterial culture to prove infections take a long time and sometimes theresult 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 causeinfectious or inflammation.Methods. This study performed at Integrated Cardiovascular Unit in RSCM, on adultpatients 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 performedbefore surgery, first, second and 5th day after surgery. Culture from other sites performedas 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 washculture (Klebsiella pneumonie), no surgical wound infection, blood and urine culturewere negative. We have PCT levels infectious group 13,48 ng/ ml and inflammationgroup 6,90 ng/ ml.Conclussion. PCT levels infectious group (13,48 ng/ ml) higher than inflammationgroup (6,90 ng/ ml). Non parametric diagnostic Mann Whitney U test there are nosignificant differences of PCT levels between infectious and inflammation group,p=0,371.] |