Korelasi Durasi Penggunaan Mesin Pintas Jantung Paru dengan Kadar Syndecan-1 pada Pasien Bedah Jantung Terbuka di RSUP Dr. Sardjito Yogyakarta

Paramita Putri Hapsari, dr. Bhirowo Yudo Pratomo, Sp.An-TI, Subsp. An.Kv(K).; DR. dr. Juni Kurniawaty, MSc, Sp.An-TI, Subs. An.Kv(K)

2024 | Tesis-Subspesialis | SUBSPESIALIS ANESTESIOLOGI DAN TERAPI INTENSIF

Pendahuluan: Durasi mesin pintas jantung paru (PJP) yang panjang berkaitan dengan inflamasi dan shear stress yang menyebabkan degradasi lapisan glikokaliks endotel sehingga terjadi pelepasan syndecan-1 ke dalam plasma. Peningkatan kadar syndecan-1 berhubungan dengan berbagai macam risiko dan komplikasi perioperatif pada pasien bedah jantung.

Tujuan: Penelitian ini bertujuan untuk mencari korelasi antara durasi mesin PJP dengan kadar syndecan-1 pada pasien bedah jantung terbuka di RSUP Dr. Sardjito Yogyakarta.

Metode: Penelitian ini merupakan penelitian analitik observasional dengan desain kohort prospektif. Penelitian ini melibatkan 35 subjek yang dilakukan pemeriksaan kadar syndecan-1. Uji korelasi dilakukan untuk menilai hubungan durasi mesin PJP dengan perubahan kadar syndecan-1, sedangkan analisis bivariat dan multivariate dilakukan untuk menilai variabel lain yang mungkin berpengaruh terhadap syndecan-1 seperti usia, kadar gula darah, albumin, komorbid pasien, jenis operasi, dan balance cairan.

Hasil: Sebagian besar subjek penelitian adalah perempuan (60,6%). Rerata usia subjek adalah 44,61±15,39 tahun dengan jenis operasi terbanyak adalah operasi katup (51,5%). Rerata durasi mesin PJP adalah 93,00±43,77 menit. Hasil uji korelasi Spearman menunjukkan bahwa terdapat korelasi positif antara durasi mesin PJP dengan perubahan kadar syndecan-1 (r:0,621, p<0>

Kesimpulan: Terdapat korelasi positif antara durasi mesin pintas jantung paru dengan kadar syndecan-1 pada pasien bedah jantung terbuka di RSUP Dr. Sardjito Yogyakarta.

Introduction: Prolonged cardiopulmonary bypass (CPB) time is related to inflammation and shear stress which causes degradation of the endothelial glycocalyx layer resulting in the release of syndecan-1 into the plasma. High levels of syndecan-1 are associated with various risks and perioperative complications in cardiac surgery patients.

Objective: The aim of this study is to find the correlation between CPB time and syndecan-1 level in cardiac surgery patients at RSUP Dr. Sardjito Yogyakarta. Methods: This research is an observational analytical study with a prospective cohort design. This study involved 35 subjects whose syndecan-1 levels were examined. Correlation tests were carried out to assess the relationship between CPB time and changes in syndecan-1 levels, while bivariate and multivariate analyzes were carried out to assess other variables that might influence syndecan- 1 such as age, blood sugar levels, albumin, patient comorbidities, type of surgery, and fluid balance.

Results: Most of the research subjects were women (60.6%). The mean age of the subjects was 44.61 ± 15.39 years with the most common type of surgery being valve surgery (51.5%). The mean CPB time was 93.00 ± 43.77 minutes. There was a significant difference between groups with longer CPB time and shorter CPB time (p: 0.015). The results of the Spearman correlation test showed that there was a positive correlation between CPB time and changes in syndecan-1 levels (r:0.621, p<0>

Conclusion: There is a positive correlation between CPB time and syndecan-1 levels in open heart surgery patients at RSUP Dr. Sardjito Yogyakarta.

Kata Kunci : durasi mesin pintas jantung paru, lapisan glikokaliks endotel, inflamasi, kadar syndecan-1, operasi bedah jantung, cardiac surgery, cardiopulmonary bypass time, endothelial glycocalyx layer, inflammation, syndecan-1