Tatalaksana Acute Respiratory Distress Syndrome Pada Pasien Dewasa Dengan Steroid

Abstract

Abstract: Acute Respiratory Distress Syndrome (ARDS) is a non-cardiogenic pulmonary edema caused by several risk factors and is an emergency case. ARDS characterized by acute intervals, alveolar edema, acute hypoxemia, decreased pulmonary compliance and multi-organ dysfunction or decreased organ function. ARDS often treated in an intensive care unit along with underlying factors. Although many medical treatments ineffective in treating ARDS, corticosteroids can reduce fluid in the alveolar capillaries and the attachment of neutrophils to endothelial capillaries. Aim of this study was to look at indicators of ARDS with steroids looking at the mortality rate, ventilator-free days, and length of stay for ARDS with steroids. Search data using three databases, namely Pubmed, Sciencedirect, Google Scholar. Ten literatures met the inclusion and exclusion criteria. Consisted of one retrospective observational study, one analytical retrospective study, three randomized control trials and five cohort studies. Total sample in 10 literatures was 1633 people for the steroid therapy group and 1303 for the control group. Result of a literature review study showed that steroids had less impact on reducing mortality in ARDS patients, steroids had an effect on increasing the number of ventilator-free days and steroids did not have an impact on increasing length of stay.

Keywords: Acute Respiratory Distress Syndrome, Steroid

Abstrak: Acute Respiratory Distress Syndrome (ARDS) merupakan edema pulmoner non-kardiogenik yang disebabkan beberapa faktor risiko dan merupakan kasus kegawatdaruratan. Karakteristik ARDS terjadi dalam selang waktu pendek atau akut, edema alveolar, hipoksemia akut, penurunan komplians paru serta multiple organ disfunction atau penurunan fungsi organ. ARDS sering dirawat dalam ruang rawat intensif beserta faktor-faktor yang mendasari. Meskipun banyak sekali pengobatan medikamentosa yang tidak efektif dalam pengobatan ARDS, namun kortikosteroid mampu mengurangi tembusnya cairan pada membran kapiler alveolar dan perlekatan neutrofil pada kapiler endotel. Tujuan dari studi ini adalah mengetahui tatalaksana ARDS dengan steroid dengan melihat angka mortalitas, ventilator free days, dan length of stay dari tatalaksana ARDS dengan steroid. Pencarian data menggunakan tiga database yaitu Pubmed, Sciencedirect, Google Scholar. Sepuluh literature yang memenuhi kriteria inklusi dan eksklusi. Terdiri dari satu penelitian retrospective observational, satu penelitian retrospective analysis, tiga penelitian randomized control trial dan lima penelitian cohort study. Jumlah sampel penelitian pada 10 literature tersebut adalah 1633 orang untuk grup terapi steroid dan 1303 untuk grup kontrol. Hasil penelitian literature review menunjukkan steroid kurang memberi dampak dalam mengurangi angka mortalitas pada pasien ARDS, steroid memberi dampak dalam peningkatan angka ventilator free days dan steroid tidak memiliki dampak yang bermakna pada peningkatan length of stay.

Kata Kunci: Acute Respiratory Distress Syndrome, Steroid.