Profil Pasien dengan Gangguan Elektrolit yang Dirawat di Ruang Perawatan Intensif
DOI:
https://doi.org/10.35790/msj.v7i2.58877Abstract
Abstract: Electrolyte disturbance is a common health problem in critical patients in the Intensive Care Unit (ICU). These disorders can cause serious complications and contribute to increased morbidity and mortality. This study aimed to determine the description of electrolyte disturbances experienced by patients in the ICU of Prof. Dr. R. D. Kandou Hospital. This was an observational study with a retrospective design involving 252 patients admitted to the ICU with electrolyte disturbances from January to June 2023. Data were obtained from medical records and analyzed descriptively. The results showed that hyponatremia was the most common electrolyte disorder (65.1%), followed by hypokalemia (48%), hypochloremia (53.6%), hypocalcemia (61.5%), and hyperphosphatemia (40.5%). The highest incidence was in the age group >65 years (18.7% for hyponatremia and hypocalcemia). The majority of patients were male. The most common disease diagnosis was sepsis. In conclusion, hyponatremia and hypocalcemia are the main electrolyte disorders in critical patients in the ICU of Prof. Dr. R. D. Kandou Hospital. The high-risk group is elderly men with sepsis. Close monitoring of electrolytes needs to be done especially in patients with these conditions to prevent fatal complications.
Keywords: electrolyte disturbance; hyponatremia; hypocalcemia
Abstrak: Gangguan elektrolit merupakan masalah yang sering terjadi pada pasien kritis di Intensive Care Unit (ICU). Penelitian ini bertujuan mengetahui profil pasien dengan gangguan elektrolit di ICU RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ialah observasional retrospektif dan pendekatan kuantitatif. Sampel penelitian ialah 252 pasien dengan gangguan elektrolit yang dirawat di ICU RSUP Prof. Dr. R. D. Kandou periode Januari-Juni 2023. Pengambilan sampel dilakukan secara purposive sampling. Variabel yang diteliti meliputi jenis gangguan elektrolit, karakteristik pasien (usia, jenis kelamin), diagnosis penyakit, dan lama rawat inap. Data dikumpulkan dari rekam medis dan dianalisis secara deskriptif. Hasil penelitian mendapatkan gangguan elektrolit terbanyak ialah hiponatremia (65,1%) dan hipokalsemia (61,5%). Kelompok usia >65 tahun (18,7%) dan laki-laki lebih banyak mengalami gangguan elektrolit, dan diagnosis tersering ialah sepsis. Rerata lama rawat inap pasien 1-7 hari. Simpulan penelitian ini ialah hiponatremia dan hipokalsemia merupakan gangguan elektrolit yang paling umum terjadi pada pasien ICU RSUP Prof. Dr. R. D. Kandou. Pasien usia lanjut dan sepsis berisiko tinggi mengalami gangguan elektrolit.
Kata kunci: gangguan elektrolit; hiponatremia; hipokalsemia
References
Ode L, Laoh J, Lombogia M, Tangka J, Momongan N, Legi N. Bunga Rampai Keperawatan Dasar. Cilacap: PT Madia Pustaka Indo; 2023.
Lee JW. Fluid and electrolyte disturbances in critically ill patients. Electrolyte Blood Press. 2010;8(2):72-81. Doi: 10.5049/EBP.2010.8.2.72
Setiarto HB, Br Karo M. Pengantar Biokimia Klinis. Bogor: Guepedia; 2020.
Chowdhury D, Duggal A. Intensive care unit models: Do you want them to be open or closed? A critical review. Nerol India. 2017;65(1):39-45. Doi: 10.4103/0028-3886.198205
Padhi R, Panda BN, Jagati S, Patra SC. Hyponatremia in critically ill patients. Indian J Crit Care Med. 2014;18(2):83-7. Doi: 10.4103/0972-5229.126077
Friedman B, Ciruli J. Hyponatremia in critically patients frequency, outcome characteristics and treatment with the vasopressin v2 receptor antagonist tolvaptan. J Crit Care. 2013;28(2):219.e1-12. Doi: 10.1016/j.jcrc.2012.06.001.
Schlanger LE, Bailey JL, Sands JM. Electrolytes in the aging. Advances in Chronic Kidney Disease. 2010;17(4):308–19. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901254/
Ekpe EL, Uhegbu KO, Orji IK, Uhegbu VM, Osuji KC, Ejikem Eke CM. Pattern of electrolyte profile among admitted children (1-18 years) at the University of Calabar Teaching Hospital, Nigeria. Med Res Chronicles. 2020;7(1):06-12. Available from: https://medrech.com/index.php/medrech/article/view/410
Naseem F, Saleem A, Mahar IA, Arif F. Electrolyte imbalance in critically ill paediatric patients. Pak J Med Sci. 2019;35(4):1093-1098. Doi: https://doi.org/10.12669/pjms.35.4.286
Lindner G, Pfortmüller CA, Leichtle AB, Fiedler GM, Exadaktylos AK. Age-related variety in electrolyte levels and prevalence of dysnatremias and dyskalemias in patients presenting to the emergency department. Gerontology. 2014;60(5):420–3. Available from: https://pubmed.ncbi.nlm.nih.gov/24854398/
Pani A, Inglese E, Puoti M, Cento V, Alteri C, Romandini A, et al. Sex differences in electrolyte imbalances caused by SARS-CoV-2: A cross-sectional study. Int J Clin Pract. 2021;75(12):e14882. doi: 10.1111/ijcp.14882.
Zhang L, Xu F, Li S, Zheng X, Zheng S, Liu H, et al. Influence of fluid balance on the prognosis of patients with sepsis. BMC Anesthesiology. 2021;21(1):269. Available from: https://doi.org/10.1186/s12871-021-01489-1
Moranne O, Froissart M, Rossert J, Gauci C, Boffa JJ, Haymann JP, et al. Timing of onset of CKD-related metabolic complications. J Am Soc Nephrol. 2008;20(1):164–71. doi: 10.1681/ASN.2008020159
Li H, Chen J, Hu Y, Cai X, Tang D, Zhang P. Clinical value of serum calcium in elderly patients with sepsis. Am J Emerg Med. 2022;52:208–11. doi: 10.1016/j.ajem.2021.12.019
Filis C, Vasileiadis I, Koutsoukou A. Hyperchloraemia in sepsis. An Intensive Care. 2018;8(1):43. doi: 10.1186/s13613-018-0388-4.
Oh HJ, Kim SJ, Kim YC, Kim EJ, Jung IY, Oh DH, et al. An increased chloride level in hypochloremia is associated with decreased mortality in patients with severe sepsis or septic shock. Sci Rep. 2017;7(1):15883. Available from: https://www.nature.com/articles/s41598-017-16238-z#Sec2
Velissaris D, Karamouzos V, Pierrakos C, Aretha D, Karanikolas M. Hypomagnesemia in critically ill sepsis patients. J Clin Med Res. 2015;7(12):911–8. doi: 10.14740/jocmr2351w
Toptas M, Sengul SN, Akkoc İ, Yucetas E, Cebeci E, Sen O, et al. Factors affecting the length of stay in the intensive care unit: our clinical experience. BioMed Res Int. 2018;2018:9438046. doi: 10.1155/2018/9438046
Penfold JA, Wells CI, Du P, Qian A, Vather R, Bissett IP, et al. Relationships between serum electrolyte concentrations and ileus: a joint clinical and mathematical modeling study. Physiol Rep. 2021;9(3):e14735. doi: 10.14814/phy2.14735
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