[ABSTRAK
Latar Belakang: Insiden dan case fatality rate pasien terinfeksi dengue diIndonesia masih tinggi. Penyebab kematian utama pada infeksi dengue adalahrenjatan yang disebabkan oleh kebocoran plasma. Kejadian hiponatremia danhipokalemia sering ditemukan pada pasien yang mengalami infeksi dengue, namunkeduanya tidak termasuk penanda kebocoran plasma dalam kriteria DBD olehWHO. Penelitian ini bertujuan untuk mengetahui rerata penurunan kadar natriumdan kalium serum pada pasien terinfeksi dengue dengan atau tanpa kebocoranplasma, dan mengonfirmasi penelitian sebelumnya apakah kadar natrium dankalium bisa dipakai sebagai penanda kebocoran plasma.Metode: Studi kohort prospektif dilaksanakan pada pasien terinfeksi dengue ≥ 16tahun dengan demam mendadak ≤ 3 hari yang dirawat di ruang rawat inap PenyakitDalam RS Cipto Mangunkusumo dan RS Persahabatan Jakarta pada pada Agustus2013-Juni 2014. Dilakukan pemeriksaan natrium serum, kalium serum, albumin,dan ultrasonografi untuk melihat adanya penebalan kandung empedu, asites danefusi pleura pada pasien terinfeksi dengue pada hari pertama masuk perawatan danhari kelima demam. Untuk mendapatkan rerata penurunan natrium dan kaliumserum antara pasien terinfeksi dengue yang mengalami kebocoran plasma dan yangtidak, digunakan uji komparatif t-test tidak berpasangan.Hasil: Terdapat 35 orang subjek penelitian pasien terinfeksi dengue yang diambilsecara konsekutif. Rerata kadar natrium serum pada pasien Demam Dengue (DD)pada saat masuk 134,66 ± 4,00 mEq/L dan pada hari kelima demam 130,95 ± 4,80mEq/L. Sementara pada pasien Demam Berdarah Dengue (DBD) didapatkan kadarnatrium pada saat masuk 132,469 ± 3,45 mEq/L dan pada saat hari kelima 129,35± 2,67 mEq/L. Perbedaan rerata penurunan kadar natrium antara pasien DBDdengan DD sebesar 0,43 mEq/L, IK 95% [-2,56; 3,42], p = 0,386. Rerata kadarkalium serum pada pasien DD pada saat masuk 3,48 ± 0,44 mEq/L dan pada harikelima demam 3,39 ± 0,38 mEq/L. Sementara pada pasien DBD didapatkan reratakadar kalium pada saat masuk 3,32 ± 0,25 mEq/L dan pada hari kelima demam 3,11± 0,30 mEq/L. Perbedaan rerata penurunan kadar kalium pasien DBD dengan DDsebesar 0,12 mEq/L, IK 95% [-0,34; 0,10], p = 0,145.Simpulan: Tidak didapatkan perbedaan rerata penurunan kadar natrium dan kaliumserum pada pasien terinfeksi dengue dengan kebocoran plasma dibandingkandengan tanpa kebocoran plasma.
ABSTRACT
Background: Incidence and case fatality rate of dengue-infected patients inIndonesia is still high. The main causes of death in dengue infection is shock causedby plasma leakage. The incidence of hyponatremia and hypokalemia often found inpatients with dengue infection, but they do not include markers of plasma leakagein DHF criteria by WHO. This study aims to determine the average decrease ofserum sodium and potassium levels in patients infected with dengue with or withoutplasma leakage, and confirm previous studies whether the levels of sodium andpotassium can be used as a marker of plasma leakage.Method: A prospective cohort study conducted in patients infected with dengue ≥16 years old with sudden fever ≤ 3 days treated in Cipto Mangunkusumo Hospitaland Persahabatan Hospital in Jakarta between August 2013 to June 2014. Checkingserum sodium, potassium, albumin, and ultrasound to see the thickening of the gallbladder, ascites and pleural effusion in patients infected with dengue on the firstday of treatment and the fifth day of fever. We used comparative unpaired t-test toobtain an average decrease in serum levels of sodium and potassium betweendengue infected patients who undergo plasma leakage and are not.Results: There were 35 research subjects infected with dengue taken consecutively.The average of serum sodium levels in patients with Dengue Fever (DF) at the timeof entry was 134,66 ± 4,00 mEq/L and on the fifth day of fever was 130,95 ± 4,80mEq/L. While in patients with Dengue Hemorrhagic Fever (DHF) obtained sodiumlevels at the time of entry was 132,469 ± 3,45 mEq/L and on the fifth day of feverwas 129,35 ± 2,67 mEq/L. The difference of the average of decreased level ofsodium between DHF and DF patients was 0,43 mEq/L, CI 95% [-2,56; 3,42], p =0,386. The average of serum potassium levels in patients with DF at the time ofentry was 3,48 ± 0,44 mEq/L and on the fifth day of fever was 3,39 ± 0,38 mEq/L.While in patients with DHF, obtained potassium levels at the time of entry was 3,32± 0,25 mEq/L and on the fifth day of fever was 3,11 ± 0,30 mEq/L. The differenceof the average of decreased level of potassium between DHF and DF patients was0,12 mEq/L, CI 95% [-0,34; 0,10], p = 0,145.Conclusion: There were no differences in average of decreased level of serumsodium and potassium in dengue-infected patients with plasma leakage comparedto without plasma leakage;Background: Incidence and case fatality rate of dengue-infected patients inIndonesia is still high. The main causes of death in dengue infection is shock causedby plasma leakage. The incidence of hyponatremia and hypokalemia often found inpatients with dengue infection, but they do not include markers of plasma leakagein DHF criteria by WHO. This study aims to determine the average decrease ofserum sodium and potassium levels in patients infected with dengue with or withoutplasma leakage, and confirm previous studies whether the levels of sodium andpotassium can be used as a marker of plasma leakage.Method: A prospective cohort study conducted in patients infected with dengue ≥16 years old with sudden fever ≤ 3 days treated in Cipto Mangunkusumo Hospitaland Persahabatan Hospital in Jakarta between August 2013 to June 2014. Checkingserum sodium, potassium, albumin, and ultrasound to see the thickening of the gallbladder, ascites and pleural effusion in patients infected with dengue on the firstday of treatment and the fifth day of fever. We used comparative unpaired t-test toobtain an average decrease in serum levels of sodium and potassium betweendengue infected patients who undergo plasma leakage and are not.Results: There were 35 research subjects infected with dengue taken consecutively.The average of serum sodium levels in patients with Dengue Fever (DF) at the timeof entry was 134,66 ± 4,00 mEq/L and on the fifth day of fever was 130,95 ± 4,80mEq/L. While in patients with Dengue Hemorrhagic Fever (DHF) obtained sodiumlevels at the time of entry was 132,469 ± 3,45 mEq/L and on the fifth day of feverwas 129,35 ± 2,67 mEq/L. The difference of the average of decreased level ofsodium between DHF and DF patients was 0,43 mEq/L, CI 95% [-2,56; 3,42], p =0,386. The average of serum potassium levels in patients with DF at the time ofentry was 3,48 ± 0,44 mEq/L and on the fifth day of fever was 3,39 ± 0,38 mEq/L.While in patients with DHF, obtained potassium levels at the time of entry was 3,32± 0,25 mEq/L and on the fifth day of fever was 3,11 ± 0,30 mEq/L. The differenceof the average of decreased level of potassium between DHF and DF patients was0,12 mEq/L, CI 95% [-0,34; 0,10], p = 0,145.Conclusion: There were no differences in average of decreased level of serumsodium and potassium in dengue-infected patients with plasma leakage comparedto without plasma leakage, Background: Incidence and case fatality rate of dengue-infected patients inIndonesia is still high. The main causes of death in dengue infection is shock causedby plasma leakage. The incidence of hyponatremia and hypokalemia often found inpatients with dengue infection, but they do not include markers of plasma leakagein DHF criteria by WHO. This study aims to determine the average decrease ofserum sodium and potassium levels in patients infected with dengue with or withoutplasma leakage, and confirm previous studies whether the levels of sodium andpotassium can be used as a marker of plasma leakage.Method: A prospective cohort study conducted in patients infected with dengue ≥16 years old with sudden fever ≤ 3 days treated in Cipto Mangunkusumo Hospitaland Persahabatan Hospital in Jakarta between August 2013 to June 2014. Checkingserum sodium, potassium, albumin, and ultrasound to see the thickening of the gallbladder, ascites and pleural effusion in patients infected with dengue on the firstday of treatment and the fifth day of fever. We used comparative unpaired t-test toobtain an average decrease in serum levels of sodium and potassium betweendengue infected patients who undergo plasma leakage and are not.Results: There were 35 research subjects infected with dengue taken consecutively.The average of serum sodium levels in patients with Dengue Fever (DF) at the timeof entry was 134,66 ± 4,00 mEq/L and on the fifth day of fever was 130,95 ± 4,80mEq/L. While in patients with Dengue Hemorrhagic Fever (DHF) obtained sodiumlevels at the time of entry was 132,469 ± 3,45 mEq/L and on the fifth day of feverwas 129,35 ± 2,67 mEq/L. The difference of the average of decreased level ofsodium between DHF and DF patients was 0,43 mEq/L, CI 95% [-2,56; 3,42], p =0,386. The average of serum potassium levels in patients with DF at the time ofentry was 3,48 ± 0,44 mEq/L and on the fifth day of fever was 3,39 ± 0,38 mEq/L.While in patients with DHF, obtained potassium levels at the time of entry was 3,32± 0,25 mEq/L and on the fifth day of fever was 3,11 ± 0,30 mEq/L. The differenceof the average of decreased level of potassium between DHF and DF patients was0,12 mEq/L, CI 95% [-0,34; 0,10], p = 0,145.Conclusion: There were no differences in average of decreased level of serumsodium and potassium in dengue-infected patients with plasma leakage comparedto without plasma leakage] |
T-Rio Zakaria.pdf :: Unduh