HUBUNGAN RASIONALITAS PEMBERIAN INFUS ALBUMIN DENGAN LUARAN KLINIS PADA PASIEN SIROSIS HATI DI RAWAT INAP RSUD ARIFIN ACHMAD RIAU

DESNITA STEVANI, Dr. Arief Nurrochmad, M.Si., M.Sc., Apt;Dr. dr. Probosuseno, Sp.PD., K.Ger

2018 | Tesis | MAGISTER FARMASI KLINIK

Albumin adalah protein di dalam plasma yang memiliki fungsi fisiologis penting diantaranya mempertahankan tekanan onkotik, dan transportasi berbagai obat-obatan didalam tubuh. Kondisi hipoalbuminemia didefinisikan dengan nilai albumin intravaskular <3,5 g/dL, namun signifikan secara klinis tampak ketika kadar serum albumin <2,5 g/dL. Setiap penurunan kadar serum albumin 1 g/dL dihubungkan dengan mortalitas, dan morbiditas. Penelitian ini bertujuan untuk mengetahui rasionalitas pemberian infus albumin,hubungan rasionalitas infus albumin dengan capaian kadar serum albumin pasca transfusi, hubungan capaian kadar serum albumin pasca transfusi dengan luaran klinis dan faktor-faktor yang mempengaruhi perubahan kadar serum albumin. Penelitian ini merupakan penelitian observasional dengan rancangan metoda cross sectional. Pengambilan data dilakukan secara retrospektif di RSUD Arifin Achmad Riau. Data dianalisis dari rekam medis pasien sirosis hati periode Januari 2016-Desember 2017 yang memenuhi kriteria inklusi. Pasien yang memenuhi kriteria analisis dilakukan analisis deskriptif. Rasionalitas infus albumin menggunakan pedoman Recommendations for the use of albumin and immunoglobulins (2009). Data rasionalitas infus albumin dengan capaian kadar serum albumin pasca transfusi dan data capaian kadar serum albumin pasca transfusi dengan luaran klinis dianalisis dengan uji statistik Fisher. Hasil penelitian terdapat 68 pasien yang memenuhi kriteria inklusi. Dengan jumlah kasus sebanyak 88 kasus. Persentase pemberian infus albumin pada pasien sirosis hati di instalasi rawat inap RSUD Arifin Achmad Riau sebanyak 90,9% (80 kasus) rasional dan 9,1% (8 kasus) tidak rasional. Dari profil pasien yaitu jenis kelamin, usia, indeks massa tubuh, jenis komorbid dan jumlah komorbid tidak diperoleh hubungan yang signifikan terhadap rasionalitas pemberian infus albumin (p>0,05). Hasil analisis menunjukkan tidak terdapat hubungan antara rasionalitas pemberian infus albumin terhadap capaian kadar serum albumin pasca transfusi dan capaian kadar serum albumin pasca transfusi terhadap luaran klinis (p>0,05).

Albumin is a protein in the plasma that has important physiological functions such as maintaining oncotic pressure, and transporting various medicines in the body. The condition of hypoalbuminemia is defined byserum albumin level<3.5 g/dL, but this condition is clinically significant when serum albumin levels <2.5 g/dL. Any decrease in serum albumin level of 1 g/dL was associated with mortality, and morbidity. This study aims to determine the rationality of albumin infusion, the relationship between rationality of albumin infusion and the achievement of serum albumin level after transfusion, the relationship between achievement of serum albumin level after transfusion and the clinical outcome and also factors influencing the change of serum albumin level. This study is an observational research with cross sectional method design. Data retrieval has been done retrospectively in RSUD Arifin Achmad Riau. Data were analyzed from medical records of liver cirrhosis patients from January 2016 to December 2017 who met the inclusion criteria. The rationality of albumin infusion was assessed using Recommendations for the use of albumin and immunoglobulins guidelines (2009). The relationship between the rationality of albumin infusion and the achievement of serum albumin level after transfusion and also the relationship between the achievement of serum albumin post-transfusion clinicaly outcome were analyzed by Fisher statistic test. There were 68 patients who met the inclusion criteria. With the number of cases as many as 88 cases. The percentage of albumin infusion in liver cirrhosis patients was 90,9% (80 cases) rational and 9,1% (8 cases) irrational. From the patient's profile ie sex, age, body mass index, comorbid type, and comorbid number, there was no significant correlation to rationality of infusion of albumin (p> 0,05). The result of the analysis showed that there was no correlation between rationality of infusion of albumin to post-transfusion albumin serum achievement and post-transfusion albumin serum level achievement to clinical outcome (p> 0,05).

Kata Kunci : Kata Kunci: Infus Albumin, Rasionalitas, Sirosis Hati, Hipoalbuminemia.