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Hubungan antara kadar pH dengan jumlah disfungsi organ dan luaran pada pasien anak dengan sepsis

  • I Gede Ardi Pratama ,
  • Dyah Kanya Wati ,
  • Ida Bagus Gde Suparyatha ,

Abstract

Background: Sepsis is defined as life-threatening organ dysfunction caused by dysregulation of the body's response to infection. In sepsis, there is a change in the balance of inflammatory and hemostatic pathways, one of which is the body's acid base. Changes in blood acid-base levels in sepsis patients can trigger multi-organ failure and result in death. The aim of this study was to analyze the effect of pH on the number of organ dysfunctions and outcomes in pediatric patients with sepsis at RSUP Prof. Dr. I G.N.G Ngoerah Denpasar.

Methods: This research is an observational analytical study with a retrospective cohort design using medical record data which aims to analyze the effect of pH levels on the number of organ dysfunctions and outcomes in pediatric patients with sepsis. The research was carried out retrospectively from medical records for the period March 2022 to September 2023. Data collection and processing activities were carried out at Prof. Dr. I G.N.G Ngoerah Hospital, Denpasar Bali.

Results: A total of 90 patients were obtained during the research, namely from March 2022 to September 2023. All patients were pediatric patients with sepsis who experienced problems with blood pH levels. Based on the results of interpretation of Blood Gas Analysis (AGD), it was found that 61.1% of patients experienced acidosis and 38.9% experienced alkalosis. The mortality rate in sepsis patients with blood acid-base problems is 57.8% with the highest number of organ damage being in 3 organs (24.4%). Based on the Spearman correlation, a figure of -0.472 was found with a p value <0.001 between pH and the amount of organ damage. The relationship between pH and patient outcomes was expressed in cross tabulation and the Odd Ratio value was 2.74 (95% CI = 1.14 – 6.57) with a significance of 0.022.

Conclusion: Acid base imbalance in the form of acidosis in pediatric patients with sepsis was found to be associated with more organ damage and increased risk of death outcomes compared to alkalosis.

 

 

Latar Belakang: Sepsis didefinisikan sebagai disfungsi organ yang mengancam jiwa yang disebabkan oleh disregulasi respon tubuh terhadap infeksi. Pada sepsis, terdapat perubahan keseimbangan jalur inflamasi dan hemostatik, salah satunya pada asam basa tubuh. Berubahnya kadar asam basa darah pada pasien sepsis dapat memicu terjadinya kegagalan multi organ dan mengakibatkan kematian. Tujuan dari penelitian ini adalah menganalisis pengaruh pH terhadap jumlah disfungsi organ dan luaran pada pasien anak dengan sepsis di RSUP Prof. Dr. I G.N.G Ngoerah Denpasar.

Metode: Penelitian ini adalah sebuah studi analitik observasional dengan desain cohort retrospective menggunakan data rekam medis yang bertujuan untuk menganalisis pengaruh kadar pH terhadap jumlah disfungsi organ dan luaran pada pasien anak dengan sepsis. Penelitian sudah dilakukan secara retrospektif dari rekam medis periode Maret 2022 hingga September 2023. Aktivitas pengumpulan dan pengolahan data dilakukan di RSUP Prof. Dr. I G.N.G Ngoerah, Denpasar Bali.

Hasil: Sebanyak 90 pasien didapatkan selama penelitian berlangsung yaitu pada bulan Maret 2022 sampai September 2023. Semua pasien merupakan pasien anak dengan sepsis yang mengalami permasalahan kadar pH darah. Berdasarkan hasil interpretasi dari Analisa Gas Darah (AGD) ditemukan sebanyak 61,1% pasien mengalami keadaan asidosis dan 38,9% mengalami alkalosis. Angka kematian pada pasien sepsis dengan permasalahan asam basa darah adalah 57,8% dengan jumlah kerusakan organ terbanyak adalah pada 3 organ (24,4%). Berdasarkan korelasi Spearman ditemukan angka -0,472 dengan nilai p <0,001 antara pH dan jumlah kerusakan organ. Hubungan antara pH dengan luaran pasien dinyatakan pada tabulasi silang dan didapatkan nilai Odd Ratio adalah 2,74 (95%IK= 1,14 – 6,57) dengan signifikansi 0,022.

Simpulan: Ketidakseimbangan asam basa berupa asidosis pada pasien anak dengan sepsis ditemukan berhubungan dengan kerusakan organ yang lebih banyak dan meningkatkan risiko luaran meninggal dibandingkan alkalosis.

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How to Cite

Pratama, I. G. A., Wati, D. K. ., & Suparyatha, I. B. G. . (2024). Hubungan antara kadar pH dengan jumlah disfungsi organ dan luaran pada pasien anak dengan sepsis. Intisari Sains Medis, 15(1), 126–132. https://doi.org/10.15562/ism.v15i1.1950

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I Gede Ardi Pratama
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Dyah Kanya Wati
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Ida Bagus Gde Suparyatha
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