Hubungan Laktat dengan Outcome pada Pasien Sakit Kritis yang Mengalami Asidosis Metabolik

Dona liazarti, May Valzon

Abstract


Abstrak

 Pendahuluan: Salah satu gangguan asam basa paling sering di ruang rawat intensif adalah asidosis metabolik dan menjadi indikator outcome pada pasien yang sakit kritis. Penyebab asidosis metabolik bervariasi antara lain keton, urat, fosfat, dan sulfat; tetapi peningkatan laktat diperkirakan menjadi penyebab umum asidosis metabolik. Tujuan:  untuk mengetahui hubungan antara kadar laktat dengan outcome pada pasien sakit kritis yang mengalami asidosis metabolik. Metode: Penelitian ini dilakukan pada bulan April sampai Oktober 2017 terhadap 74 pasien sakit kritis yang dirawat di ruang rawat intensif RSUP Dr. M. Djamil Padang. Kadar laktat diukur dengan metode amperometri sedangkan analisis gas darah diperiksa dengan metode potensiometri. Hasil: Uji Mann Whitney digunakan untuk mengetahui hubungan kadar laktat dengan outcome yang dinyatakan bermakna jika nilai p < 0,05.Rerata nilai pH, pO2, pCO2, HCO3, BE berturut-turut adalah 7,27 (0,09); 196,84 (91,14); 36,81 (7,71); 17,39 (4,36) dan -9,1 (5,11). Uji Mann Whitney terhadap kadar laktat dan outcome diperoleh nilai p sebesar 0,001 yang menunjukkan adanya perbedaan kadar laktat yang bermakna antara dua kelompok outcome (hidup dan meninggal). Kesimpulan: Peningkatan kadar laktat memengaruhi outcome pasien sakit kritis yang mengalami asidosis metabolik.

Kata kunci---  Asidosis metabolik, sakit kritis, laktat, outcome

 

Abstract

Introduction: One of the most frequent acid-base disorders in intensive care unit is metabolic acidosis and it become indicator of outcome in critically ill patients. Metabolic acidosis caused by various states such as ketones, uric acid, phosphate, and sulfate; but lactic acid is a common etiology of metabolic acidosis. Aims: The aim of this study was analyze the association between lactate level with outcome in critically ill patients with metabolic acidosis. Method: This study was conducted from April to October 2017 in 74 critically ill patients whom hospitalized in intensive care unit department M. Djamil Hospital Padang. Lactate concentration were performed by amperometric method and blood gas analysis by potentiometric. Results: Mann-Whitney test was used to assess association between lactate level with outcome and significant if p value less than 0.05.The mean value of pH, pO2, pCO2, HCO3, BE were 7.27 (0.09); 196.84 (91.14); 36.81 (7.71); 17.39 (4.36) and -9.1 (5.11) respectively. Mann-Whitney test showed that p value for lactate level and outcome was 0.001; it meaned there was a signifcant difference of lactate level between the group of outcomes. Conclusion: Lactate level have a significantly effect for outcome in critically ill patients with metabolic acidosis.

Keywords--- metabolic acidosis, critically ill, lactate, outcome


Keywords


Clinical Pathology

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DOI: https://doi.org/10.33854/heme.v4i1.907

DOI (PDF): https://doi.org/10.33854/heme.v4i1.907.g338

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