Latar Belakang: Penggunaan heparin inhalasi pada beberapa penelitian COVID-19memberikan hasil dalam perbaikan klinis pasien, baik dalam menurunkan lama rawat,perbaikan oksigenasi paru, dan mortalitas. Dosis harian total heparin inhalasi yangbervariasi terutama bila diberikan bersamaan dengan antikoagulan sistemik, memilikiresiko komplikasi perdarahan yang memerlukan kajian terhadap keefektifan dankeamanannya.Tujuan: Meneliti keefektifan dan keamanan inhalasi heparin dosis 150,000 IU/haridengan dosis 100.000 IU/hari dinilai dari AaDO2, aPTT dan d-Dimer dalam 7 haripengamatan pada pasien ICU COVID-19.Metode: Penelitian ini merupakan penelitian observasional dengan studi kohortretrospektif menggunakan data sekunder rekam medis pasien ICU COVID-19 bulanSeptember 2020 – September 2021. Terdapat 300 sampel menggunakan consecutivesampling. Pasien dikelompokkan menjadi kelompok heparin dosis 150.000 IU/hari dan100.000 IU/hari. Pencatatan dilakukan dalam 7 hari pengamatan. Uji Statistikmenggunakan uji Mann Whitney untuk menilai tingkat keparahan, Uji Wilcoxon rank testuntuk melihat perbedaan variabel dependen hari pertama dengan hari ketujuh padamasing-masing dosis.Hasil: Heparin inhalasi baik dosis 150.000 IU/hari dan 100.000 IU /hari bermaknamenurunkan AaDO2 pada 7 hari pengamatan (p 0.001). Nilai aPTT tidak memanjangpada kedua kelompok, dan kedua dosis heparin sama- sama menurunkan nilai d-Dimerpada 7 hari pengamatan (p 0.001).Simpulan: Heparin Inhalasi dosis 150.000 IU/hari sama efektif dinilai dari AaDO2, dansama amannya terhadap aPTT dan d-Dimer dibandingkan heparin inhalasi dosis 100.000IU/hari.
Rationale: The use of inhaled heparin in several COVID-19 studies has resulted inclinical improvements in patients, both in reducing length of treatment, improvingpulmonary oxygenation, and reducing mortality. The varying total daily dose of inhaledheparin, especially when given together with systemic anticoagulants, poses a risk ofbleeding complications that require review of its effectiveness and safety.Objective: To analyze effectiveness and safety of heparin inhalation dosage 150,000IU/day compare to 100,000 IU/day assessed from AaDO2, aPTT and d-Dimer from 7days observation in ICU COVID-19 patients with invasive and non-invasive ventilatorpatterns.Methods: An observational cohort retrospective study used secondary data from medicalrecords ICU COVID-19 patients with invasive and noninvasive ventilator patterns fromSeptember 2020 – September 2021. There were 300 samples using consecutive sampling.Patients divided into 2 groups, one received dosage 150,000 IU / day heparin inhalation,the other received heparin inhalation dosage 100,000 IU / day. Recording of the researchfrom medical records is carried out at 7 days of ICU treatment. Statistical tests werecarried out using Mann Whitney to assess severity, Wilcoxon rank test to see thedifference in dependent variables day 1 and day 7 to dose.Measurements and Main Results: Heparin inhalation at dose of 150,000 IU/day and100,000 IU/day both significantly decreased AaDO2 at 7 days of observation (p 0.001).The aPTT on both groups at 7 days of observation are within normal limits. Both dosesof heparin inhalation decreased d-dimer at 7 days of observation (p 0.001).Conclusion: Inhaled heparin doses of 150,000 IU/day as effective and as safe as inhaledheparin doses of 100,000 IU/day. |
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