Efek Perbedaan Ventilasi Mekanik Positive End Expiratory Pressure (PEEP) Low dan Moderate terhadap Rasio PaO2/FiO2 Pascabedah pada Kraniotomi Elektif

Muhammad Rizki, M. Sofyan Harahap, Satrio Adi Wicaksono

Abstract


Latar Belakang dan Tujuan: Kraniotomi elektif memiliki kejadian komplikasi paru pascaoperasi (25%) dan mortalitas (10%) yang tinggi. Penelitian ini berusaha mengetahui efek Positive End Expiratory Pressure (PEEP) 5 cmH2O and 8 cmH2O terhadap rasio PaO2/FiO2 pascaoperasi pada kraniotomi elektif
Subjek dan Metode: Uji klinis acak ini dilakukan di satu rumah sakit pendidikan di Indonesia. Lima puluh dua pasien kraniotomi elektif (usia 17-55 tahun, lama bedah >4 jam, paru normal) dirandomisasi ke dalam 2 kelompok intervensi: ventilasi mekanik perioperatif dengan low Positive End Expiratory Pressure ( PEEP) (5 cmH2O) atau moderate PEEP (8 cmH2O). Hipotesis penelitian ini adalah rasio PaO2/FiO2 kelompok moderate PEEP lebih tinggi dibandingkan low PEEP. Analisis gas darah dilakukan pada 24 jam pasca induksi
Hasil: Penelitian ini tidak menunjukkan perubahan yang signifikan rasio PaO2/FiO2 antara kelompok low PEEP dan moderate PEEP. Rasio PaO2/FiO2 kelompok low PEEP dan moderate PEEP secara berurutan adalah: pada 24 jam pasca induksi, 429,34 ± 72,25 mmHg dan 458,59 ± 71,11mmHg (p =0,147).
Simpulan: Perbandingan low PEEP dan moderate PEEP pada ventilasi mekanik perioperatif tidak menghasilkan perbedaan nilai rasio PaO2/FiO2yang signifikan pada 24 jam pasca induksi.

The Differential Effect of Low and Moderate Positive End Expiratory Pressure (PEEP) Mechanical Ventilation to Postoperative PaO2/FiO2 Ratio in Elective Craniotomy

Abstract

Background and Objective: Elective craniotomy is associated with high incidence of postoperative pulmonary complications (PPC, 25%) and mortality (10%). We determined to study the effect of Positive End Expiratory Pressure (PEEP) 5 cmH2O and 8 cmH2O to postoperative PaO2 / FiO2 ratio (PF ratio) in elective craniotomy.

Subject and Methods: This randomized clinical trial was at a university hospital in Indonesia. Fifty two elective craniotomy patients (ages 17–55 years, surgical duration> 4 hours, normal lung) were randomized into 2 intervention groups: perioperative mechanical ventilation with low PEEP (5 cmH2O) or moderate PEEP (8 cmH2O). The hypothesis of this study is that the ratio of PaO2 / FiO2 in the moderate PEEP group is higher than low PEEP. Blood gas analysis was performed 24 hours post induction.

Results: This study did not show a significant difference in the PaO2/FiO2 ratio between the low PEEP and moderate PEEP groups. The PaO2 / FiO2 ratios of the low PEEP and moderate PEEP groups were respectively: at 24 hours post induction, 429.34 ± 72.25 mmHg and 458.59 ± 71.11mmHg (p = 0.147).
Conclusions: Comparison of low PEEP and moderate PEEP in perioperative mechanical ventilation did not result in a significant difference in the value of the PaO2/FiO2 ratio at 24 hours post induction


Keywords


Positive End Expiratory Pressure (PEEP), rasio PaO2/FiO2, proteksi paru, kraniotomi elektif, komplikasi paru pascaoperasi, Positive End Expiratory Pressure (PEEP), PaO2/FiO2 ratio, lung protective, elective craniotomy complication postoperative

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DOI: https://doi.org/10.24244/jni.v9i3.252

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