Perbedaan Nilai FiO2, PaO2, Skor Hiposemik Dan Durasi Perbaikan Klinis Pasien Penyakitparu Dengan Gagal Napas Hipokemik Dengan Dan Tanpa Pemberiaan Inhalasi Hyaluronic Acid

Penulis Utama : Rocherman Gema Adyta
NIM / NIP : S602102010
× <p class="MsoNormal" xss=removed><span lang="id" xss=removed>Rocherman Gema Adytama, 2024, Tesis. Perbedaan nilai FiO</span><span lang="id" xss=removed>2</span><span lang="id" xss=removed>, PaO</span><span lang="id" xss=removed>2</span><span lang="id" xss=removed>, skor hipoksemik, dan durasi<span xss=removed> </span></span><span lang="id" xss=removed>perbaikan klinis pasien penyakit paru dengan gagal napas<span xss=removed> hipoksemik </span>dengan dan tanpa pemberian HMW-HA <span xss=removed> </span>inhalasi.<span xss=removed> </span>Pembimbing<span xss=removed> </span>I:<span xss=removed> </span>Prof.<span xss=removed> </span>Dr.<span xss=removed> </span>dr.<span xss=removed> </span>Yusup<span xss=removed> </span>Subagio<span xss=removed> </span>Sutanto,<span xss=removed> </span>Sp.P(K),<span xss=removed> </span>FISR,<span xss=removed> </span>FAPSR;<span xss=removed> </span>Pembimbing<span xss=removed> </span><span xss=removed>II</span><span xss=removed> </span><span xss=removed>:</span><span xss=removed> </span><span xss=removed>dr.</span><span xss=removed> </span>Artrien<span xss=removed> </span>Adhiputri,<span xss=removed> </span>Sp.P,<span xss=removed> </span>M.<span xss=removed> </span>BioMed,<span xss=removed> </span>Program<span xss=removed> </span>Pendidikan<span xss=removed> </span>Dokter<span xss=removed> </span>Spesialis<span xss=removed> </span>Pulmonologi<span xss=removed> </span>dan<span xss=removed> </span>Kedokteran<span xss=removed> </span>Respirasi<span xss=removed> </span>Fakultas Kedokteran<span xss=removed> </span>Universitas<span xss=removed> </span>Sebelas Maret,<span xss=removed> </span>Surakarta.<o></o></span></p><p class="MsoBodyText" xss=removed><span lang="id" xss=removed> </span></p><p class="MsoNormal" align="center" xss=removed><b><span lang="id" xss=removed>ABSTRAK<o></o></span></b></p><p class="MsoBodyText"><b><span lang="id" xss=removed> </span></b></p><p class="MsoNormal" align="center" xss=removed><b><span lang="id" xss=removed>PERBEDAAN NILAI FiO</span></b><b><span lang="id" xss=removed>2</span></b><b><span lang="id" xss=removed>, PaO</span></b><b><span lang="id" xss=removed>2</span></b><b><span lang="id" xss=removed>, SKOR HIPOKSEMIK, DAN DURASI PERBAIKAN<span xss=removed> </span></span></b><b><span lang="id" xss=removed>KLINIS PASIEN PENYAKIT PARU DENGAN GAGAL NAPAS HIPOKSEMIK DENGAN DAN TANPA </span></b><b><span lang="id" xss=removed> </span></b><b><span lang="id" xss=removed>INHALASI <i>HYALURONIC<span xss=removed> </span>ACID<o></o></i></span></b></p><p class="MsoNormal" align="center" xss=removed><span lang="id" xss=removed>Rocherman Gema Adytama, Yusup Subagio Sutanto, </span><span lang="id" xss=removed>Artrien Adhiputri<span xss=removed> </span>Departemen Pulmonologi dan Kedokteran Respirasi Fakultas Kedokteran<span xss=removed> </span>Universitas<span xss=removed> </span>Sebelas<span xss=removed> </span>Maret/RS dr.<span xss=removed> </span>Moewardi<span xss=removed> </span>Surakarta<o></o></span></p><p class="MsoBodyText" xss=removed><span lang="id" xss=removed> </span></p><p class="MsoNormal" xss=removed><b><span lang="id" xss=removed>Latar belakang</span></b><span lang="id" xss=removed>: <i>Hyaluronic acid </i>merupakan komponen utama matriks ekstraseluler. <i>Hyaluronan<span xss=removed> </span>synthases<span xss=removed> </span></i>membentuk<span xss=removed> </span><i>high-molecular<span xss=removed> </span>weight<span xss=removed> </span>hyaluronic<span xss=removed> </span>acid<span xss=removed> </span></i>(HMW-HA)<span xss=removed> </span>yang<span xss=removed> </span>bersifat<span xss=removed> </span>antiinflamasi dan bersifat higroskopik (menyerap air hingga 1.000 kali dari berat molekulnya)<span xss=removed> </span>sehingga membentuk molekul <i>gel-like fluid </i>dengan viskositas yang tinggi yang bersifat barrier<span xss=removed> </span><span xss=removed>fungsional untuk jaringan. Pada keadaan inflamasi atau cedera jaringan </span>HMW-HA akan didegradasi<span xss=removed> </span>oleh <i>hyaluronidase </i>(HYAL) atau <i>reactive species oxygen </i>(ROS) menjadi <i>low-molecular weight<span xss=removed> </span><span xss=removed>hyaluronic</span><span xss=removed> </span><span xss=removed>acid</span><span xss=removed> </span></i><span xss=removed>(LMW-HA)</span><span xss=removed> </span><span xss=removed>yang</span><span xss=removed> </span><span xss=removed>bersifat</span><span xss=removed> </span><span xss=removed>pro-inflamasi.</span><span xss=removed> </span><span xss=removed>Ketidakmampuan</span><span xss=removed> </span>sistem<span xss=removed> </span>pernapasan<span xss=removed> </span>untuk<span xss=removed> </span><span xss=removed>menjalankan</span><span xss=removed> </span><span xss=removed>fungsi</span><span xss=removed> </span><span xss=removed>pernapasan</span><span xss=removed> </span>akan<span xss=removed> </span>menyebabkan gagal<span xss=removed> </span>napas.<span xss=removed> </span>Gagal<span xss=removed> </span>napas<span xss=removed> </span>sering<span xss=removed> </span>kali<span xss=removed> </span>merupakan<span xss=removed> </span>komplikasi<span xss=removed> </span>dari<span xss=removed> </span>penyakit<span xss=removed> </span>saluran<span xss=removed> </span>napas<span xss=removed> </span>akut,<span xss=removed> </span>sepsis<span xss=removed> </span>atau<span xss=removed> </span>syok.<span xss=removed> </span><i>Proses<span xss=removed> </span>patologis<span xss=removed> </span>paru<span xss=removed> </span>yang<span xss=removed> </span>melibatkan bronki (seperti status asmatikus, bronkiolitis), inflamasi atau infeksi parenkim paru<span xss=removed> </span>(pneumonia, aspirasi, fibrosis kistik) menyebabkan obstruksi jalan napas dan kerusakan parenkim<span xss=removed> </span>sehingga terjadi V/Q missmatch dan gangguan pertukaran gas. </i>Gagal napas hipoksemia ditandai<span xss=removed> </span><span xss=removed>dengan PaO</span></span><span lang="id" xss=removed>2 </span><span lang="id" xss=removed>< 60><span lang="id" xss=removed>2 </span><span lang="id" xss=removed>< 91>P/F ratio </i>< 300><span lang="id" xss=removed>2 </span><span lang="id" xss=removed>10<span xss=removed> </span></span><span lang="id" xss=removed>mmHg</span><span lang="id" xss=removed> </span><span lang="id" xss=removed>dari</span><span lang="id" xss=removed> </span><span lang="id" xss=removed>nilai</span><span lang="id" xss=removed> </span><span lang="id" xss=removed>sebelumnya.<span xss=removed> </span>Inflamasi<span xss=removed> </span>akut<span xss=removed> </span>menyebabkan<span xss=removed> </span>HMW-HA<span xss=removed> </span>terdegradasi<span xss=removed> </span>menjadi<span xss=removed> </span>LMW-<span xss=removed> </span>HA<span xss=removed> </span>yang<span xss=removed> </span>bersifat<span xss=removed> </span>pro<span xss=removed> </span>inflamasi<span xss=removed> </span>poten.<span xss=removed> </span>Suplementasi<span xss=removed> </span>HMW-HA<span xss=removed> </span>secara<span xss=removed> </span>eksogen<span xss=removed> </span>dapat<span xss=removed> </span>mengembalikan homeostasis HA dalam bentuk yang belum terdegradasi, sehingga memperbaiki<span xss=removed> </span><span xss=removed>inflamasi,</span><span xss=removed> </span><span xss=removed>memperbaiki</span><span xss=removed> </span><span xss=removed>fungsi</span><span xss=removed> </span>paru,<span xss=removed> </span>dan<span xss=removed> </span>memperbaiki<span xss=removed> </span>progresi<span xss=removed> </span>gagal<span xss=removed> </span>napas. <i>High-molecular<span xss=removed> </span>weight<span xss=removed> </span>hyaluronic<span xss=removed> </span>acid<span xss=removed> </span></i>yang<span xss=removed> </span>diberikan<span xss=removed> </span>secara<span xss=removed> </span>inhalasi<span xss=removed> </span>atau<span xss=removed> </span>instilasi<span xss=removed> </span>trakea<span xss=removed> </span>dapat<span xss=removed> </span>berperan sebagai<span xss=removed> </span>agen<span xss=removed> </span>anti<span xss=removed> </span>inflamasi, memperbaiki <i>hyperreactive </i>jalan napas, peningkatan hidrasi mukus, perbaikan transpor<span xss=removed> </span>mukus, dan mengurangi mukus <i>plugging </i>pada jalan napas, memperlambat proses <i>remodelling </i>dan<span xss=removed> </span><span xss=removed>modifikasi biofilm saluran napas.<span xss=removed> </span>Peneliti ingin mengetahui perbedaan nilai<span xss=removed> </span>FiO</span></span><span lang="id" xss=removed>2</span><span lang="id" xss=removed>, PaO</span><span lang="id" xss=removed>2</span><span lang="id" xss=removed>, skor<span xss=removed> </span></span><span lang="id" xss=removed>hipoksemik,<span xss=removed> </span>dan<span xss=removed> </span>durasi<span xss=removed> </span>perbaikan<span xss=removed> </span>klinis<span xss=removed> </span>pasien<span xss=removed> </span>penyakit<span xss=removed> </span>paru<span xss=removed> </span>dengan<span xss=removed> </span>gagal<span xss=removed> </span>napas<span xss=removed> </span>dengan<span xss=removed> </span>dan<span xss=removed> </span>tanpa<span xss=removed> </span>pemberian<span xss=removed> </span>HMW-HA<span xss=removed> </span>inhalasi.<o></o></span></p><p class="MsoNormal" xss=removed><b><span lang="id" xss=removed>Metode</span></b><span lang="id" xss=removed>:</span><span lang="id" xss=removed> </span><span lang="id" xss=removed>Uji</span><span lang="id" xss=removed> </span><span lang="id" xss=removed>klinis</span><span lang="id" xss=removed> </span><i><span lang="id" xss=removed>quasi</span></i><i><span lang="id" xss=removed> </span></i><span lang="id" xss=removed>eksperimental</span><span lang="id" xss=removed> </span><span lang="id" xss=removed>dengan</span><span lang="id" xss=removed> </span><span lang="id" xss=removed>pendekatan</span><span lang="id" xss=removed> </span><i><span lang="id" xss=removed>pretest</span></i><i><span lang="id" xss=removed> </span></i><i><span lang="id" xss=removed>posttest<span xss=removed> </span>study<span xss=removed> </span>design<span xss=removed> </span></span></i><span lang="id" xss=removed>dan<span xss=removed> </span><i>posttest<span xss=removed> </span>only control group design </i>dilakukan pada pasien penyakit paru dengan gagal napas yang menjalani<span xss=removed> </span>perawatan di bangsal RSUD dr. Moewardi pada<span xss=removed> </span>Juli sampai dengan September<span xss=removed> </span>2024 dengan<span xss=removed> </span><i>consecutive sampling. </i>Kelompok perlakuan (n=14) mendapatkan terapi standar gagal napas dan<span xss=removed> </span>HMW-HA inhalasi sebanyak 2 kali/hari sampai mengalami perbaikan klinis. Kelompok kontrol<span xss=removed> </span><span xss=removed>(n=14)</span><span xss=removed> </span><span xss=removed>mendapatkan</span><span xss=removed> </span><span xss=removed>terapi</span><span xss=removed> </span><span xss=removed>standar</span><span xss=removed> </span><span xss=removed>gagal</span><span xss=removed> </span><span xss=removed>napas.</span><span xss=removed> </span><span xss=removed>Nilai</span><span xss=removed> </span><span xss=removed>FiO</span></span><span lang="id" xss=removed>2</span><span lang="id" xss=removed>,</span><span lang="id" xss=removed> </span><span lang="id" xss=removed>PaO</span><span lang="id" xss=removed>2</span><span lang="id" xss=removed>,<span xss=removed> </span>skor<span xss=removed> </span>hipoksemik<span xss=removed> </span>dinilai<span xss=removed> </span>pada<span xss=removed> </span>awal<span xss=removed> </span></span><span lang="id" xss=removed>dan<span xss=removed> </span>akhir penelitian.<span xss=removed> </span>Durasi<span xss=removed> </span>perbaikan klinis<span xss=removed> </span>setiap<span xss=removed> </span>kelompok didapatkan di<span xss=removed> </span>akhir penelitian.<o></o></span></p><p class="MsoNormal" xss=removed><b><span lang="id" xss=removed>Hasil: </span></b><span lang="id" xss=removed>Terdapat<span xss=removed> </span>perbedaan<span xss=removed> </span>signifikan<span xss=removed> </span>(p<0 xss=removed> </span>pada<span xss=removed> </span>nilai<span xss=removed> </span>PaO</span><span lang="id" xss=removed>2<span xss=removed> </span></span><span lang="id" xss=removed>dan<span xss=removed> </span>post<span xss=removed> </span>inhalasi<span xss=removed> </span>kelompok<span xss=removed> </span></span><span lang="id" xss=removed>perlakuan, dan saat diabandingkan dengan kelompok kontrol perbaikan pada kelompok perlakuan<span xss=removed> </span>signifikan<span xss=removed> </span>secara<span xss=removed> </span>statistik<span xss=removed> </span>(p=</span><span lang="id">0.043)</span><span lang="id" xss=removed>.<span xss=removed> </span>Terdapat<span xss=removed> </span>perbaikan<span xss=removed> </span>nilai<span xss=removed> </span>skor<span xss=removed> </span>hipoksemik<span xss=removed> </span>(p<0 xss=removed> </span><span xss=removed>penurunan FiO</span></span><span lang="id" xss=removed>2 </span><span lang="id" xss=removed>(p= 0.002) dan durasi perbaikan klinis yang lebih cepat (p=</span><span lang="id" xss=removed>0.101) pre dan post<span xss=removed> </span></span><span lang="id">inhalasi </span><span lang="id" xss=removed>pada kelompok perlakuan, namun saat dibandingkan dengan kelompok kontrol tidak<span xss=removed> </span>bermakna<span xss=removed> </span>secara<span xss=removed> </span>statistik<span xss=removed> </span>(p<span xss=removed> </span>><span xss=removed> </span>0.05).<o></o></span></p><p class="MsoNormal" xss=removed><b><span lang="id" xss=removed>Simpulan: </span></b><span lang="id" xss=removed>Pemberian HMW-HA inhalasi sebagai terapi tambahan penyakit paru dengan gagal<span xss=removed> </span><span xss=removed>napas<span xss=removed> </span>dapat<span xss=removed> </span>meningkatkan<span xss=removed> </span>nilai<span xss=removed> </span>PaO</span></span><span lang="id" xss=removed>2<span xss=removed> </span></span><span lang="id" xss=removed>secara<span xss=removed> </span>signifikan.</span><span lang="id" xss=removed><o></o></span></p><p> </p><p class="MsoNormal" xss=removed><br></p>
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Penulis Utama : Rocherman Gema Adyta
Penulis Tambahan : -
NIM / NIP : S602102010
Tahun : 2024
Judul : Perbedaan Nilai FiO2, PaO2, Skor Hiposemik Dan Durasi Perbaikan Klinis Pasien Penyakitparu Dengan Gagal Napas Hipokemik Dengan Dan Tanpa Pemberiaan Inhalasi Hyaluronic Acid
Edisi :
Imprint : Surakarta - Fak. Kedokteran - 2024
Program Studi : PPDS Pulmonologi
Kolasi :
Sumber :
Kata Kunci : Kata kunci: Hyaluronic acid, inhalasi, penyakit paru, gagal napas, FiO2, PaO2, skor hipoksemik.
Jenis Dokumen : Tesis
ISSN :
ISBN :
Link DOI / Jurnal : http:// http://www.jurnalrespirologi.org/
Status : Public
Pembimbing : 1. Prof. Dr. dr. Yusup Subagio Sutanto, Sp.P(K), FISR, FAPSR
2. dr. Artrien Adhiputri, Sp.P (K), M.Biomed
Penguji : 1. dr. A. Farih Raharjo, Sp.P(K), M.Kes, FISR
2. Dr.dr. Harsini, Sp.P (K), FISR, MMR
Catatan Umum :
Fakultas : Fak. Kedokteran
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