TELAHAAH JURNAL ACUT RESPIRATORY DISTRESS SYNDROME

Di susun Oleh:

Semester 7 B

1. 2. 3. 4. 5. 6. 7. 8. 9.

Nuha Muniroh Nur Jannah Nurdiyantoro Nurhayati Loilatu Nurul Azkanuddin Piengkan Hapsari Findi Isak Sutrisno Pipit Devis Ernasari Puji Utami

G2A008101 G2A008102 G2A008103 G2A008104 G2A008105 G2A008106 G2A008107 G2A008108 G2A008109 G2A008110 G2A008111

10. Puri Lukitasari 11. Rahmanda Senjaya

PROGRAM STUDI S1 KEPERAWATAN FAKULTAS ILMU KEPERAWATAN DAN KESEHATAN UNIVERSITAS MUHAMMADIYAH SEMARANG 2011/2011

Adrian A. Salmon and John R. Hotchkiss Critical Care 2007, dalam artikelnya yang berjudul Hypercapnic acidosis in ARDS: A tolerated side effect or an important therapeutic modality, Hypercapnic acidosis was associated with reduced 28-day mortality in the 12 mL/kg PBW tidal volume group after controlling for co-morbidities and severity of lung injury. These results are consistent with a protective effect of hypercapnic acidosis against ventilator-associated lung injury that was not found when the further ongoing injury was reduced by 6 mL/kg PBW tidal volumes. The adjusted odds ratio and 95% confidence intervals (CI) for 28-day mortality rate associated with hypercapnic acidosis defined as day 1 pH <7.35 and PaCO2 >45 mm Hg were 0.14 (95% CI 0.03-0.70, p = .016) in the 12 mL/kg PBW tidal volume group and 1.18 (95% CI 0.59-2.35, p = .639) in the 6 mL/kg PBW tidal volume group. Other definitions of hypercapnic acidosis spanning a range of magnitudes suggest a dose-response association between hypercapnic acidosis and 28-day mortality in the 12 mL/kg PBW tidal volume group. None of our definitions of hypercapnic acidosis were associated with reduction in 28-day mortality in the 6 mL/kg PBW tidal volume group. Kregenow and coworkers explored the association of HA and mortality in a retrospective secondary analysis of 861 subjects with ALI/ARDS enrolled in the ARDS Network low vs. high tidal volume trial . HA was defined as day 1 pH <7.35 and PaCO2 >45 mm Hg. As with all observational studies, this study was intended to be hypothesis generating and does not prove cause and effect. The definition of HA was based on a single day 1 measurement, rather than by sustained HA over time. As noted by the authors, there were too few patients with sustained HA to evaluate its effects. Dari jurnal di atas menunjukan bahwa Hypercapnic acidosis in ARDS: A tolerated side effect or an important therapeutic modality. HA dikaitkan dengan penurunan mortalitas 28-hari pada volume tinggi pasang surut (12 ml / kg PBW), namun volume tidal tidak rendah (6 mL / kg PBW), kelompok setelah mengendalikan komorbiditas dan keparahan cedera paru-paru. Sebuah uji klinis acak HA pada pasien dengan ALI / ARDS menjalani ventilasi paru-paru pelindung tampaknya dibenarkan. Bukti menunjukkan bahwa asidosis hiperkapnia mungkin bermanfaat pada pasien dengan cedera paru-paru akut, meskipun studi tidak memisahkan efek HA dari efek dari perubahan ventilasi mekanik.