Modalitas Terapi Cairan Pada Pasien  Acute Kidney Injury dan Critical Illness: A Narrative review

Morris Lintong Barimbing; Nyoman Paramita Ayu

doi:10.56951/q0a7pn86

Modalitas Terapi Cairan Pada Pasien Acute Kidney Injury dan Critical Illness: A Narrative review

Penulis

Morris Lintong Barimbing Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran, Universitas Udayana/RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, Bali, Indonesia
Nyoman Paramita Ayu Divisi Nefrologi dan Hipertensi, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran, Universitas Udayana/RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.56951/q0a7pn86

Kata Kunci:

manajemen cairan, penyakit kritis, cedera ginjal akut

Abstrak

Manajemen cairan merupakan salah satu modalitas utama dalam tata laksana pasien dengan penyakit kritis dan cedera ginjal akut (acute kidney injury/AKI). Manajemen cairan pada pasien kritis merupakan proses yang sederhana sekaligus kompleks, karena terapi cairan dapat menjadi pedang bermata dua; di mana pemberian yang tidak adekuat maupun berlebihan dapat memperberat kerusakan organ target. Penilaian status volume pasien merupakan faktor utama dalam menentukan strategi terapi cairan pada pasien kritis dengan AKI. Jenis dan laju penggantian cairan memiliki konsekuensi terhadap luaran klinis, termasuk kejadian AKI atau risiko progresivitas AKI. Baik hipovolemia maupun peningkatan keseimbangan cairan dapat berkontribusi terhadap kejadian atau perburukan AKI melalui peningkatan tekanan vena sentral dan kongesti ginjal. Strategi penggantian cairan, termasuk jenis dan dosis cairan yang diberikan, merupakan komponen penting dalam perawatan pasien rawat inap dan memerlukan keahlian klinis yang memadai. Terapi cairan yang tidak tepat dapat menyebabkan berbagai komplikasi, termasuk asidosis metabolik, gangguan elektrolit, AKI atau progresi menjadi penyakit ginjal kronis (PGK), kelebihan volume cairan atau dehidrasi, cedera paru, ketidakseimbangan respons proinflamasi dan antiinflamasi, gangguan perfusi jaringan, serta kerusakan jaringan. Beragam komplikasi tersebut berkaitan dengan peningkatan morbiditas dan mortalitas, serta durasi rawat inap yang lebih panjang.

Unduhan

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