Hubungan Derajat Keparahan pada Pediatric Acute Respiratory Distress Syndrome (PARDS) menggunakan Oxygen Index (OI) dengan perfusi serebral menggunakan Near-Infrared Spectroscopy (NIRS)

Arif Handiarsa, Dr. dr. Nurnaningsih SpAk; dr. Amalia Setyati SpAK

2024 | Tesis-Subspesialis | SUBSPESIALIS ILMU KESEHATAN ANAK

Latar belakang: Pediatric Acute Respiratory Distress Syndrome (PARDS) dapat menyebabkan cedera otak akut melalui, inflamasi, hipoksemia dan efek samping ventilasi mekanis. Near-infrared spectroscopy (NIRS) merupakan metode non-invasif untuk memantau saturasi oksigen serebral, namun belum banyak diteliti pada PARDS.

Tujuan: Penelitian ini bertujuan untuk mengevaluasi hubungan derajat keparahan PARDS menggunakan Oxygen Index (OI) dengan perfusi serebral menggunakan NIRS.

Metode: Sebuah studi analitik observasional dengan desain potong lintang dilakukan di PICU RSUP Dr. Sardjito Yogyakarta pada bulan Mei-Oktober 2024. Subjek penelitian adalah pasien anak berusia 1 bulan - <18>Temperature (T), MAP, Penggunaan vasopressor, kadar Hb, balance cairan kumulatif, pH, pCO2, pO2 dan FTOE.

Hasil: Dari 21 pasien PARDS, tidak ada perbedaan signifikan CrSO2 antara kelompok Mild/Moderate PARDS (72,25 ± 17,54) dan Severe PARDS (65,89 ± 19,30), (p=0,440). Tidak ada perbedaan signifikan CrSO2 antara kelompok Temperature (p=0,485), MAP (p=0,734) maupun Penggunaan vasopressor (p=0,307). Tidak ditemukan korelasi signifikan antara kadar Hb, balance cairan kumulatif, pH, pCO2, dan pO2 dengan CrSO2 (p>0,05). Terdapat perbedaan signifikan CrSO2 di antara kelompok FTOE (p<0>

Kesimpulan: Tidak ada hubungan signifikan antara derajat PARDS dengan perfusi serebral NIRS, namun terdapat perbedaan signifikan CrSO2 antar kelompok FTOE. 

Background: Pediatric Acute Respiratory Distress Syndrome (PARDS) can cause acute brain injury through inflammation, hypoxemia and side effects of mechanical ventilation. Near-infrared spectroscopy (NIRS) is a non-invasive method to monitor cerebral oxygen saturation, but has not been widely studied in PARDS.    

Objective: This study aimed to evaluate the relationship of PARDS severity using Oxygen Index (OI) with cerebral perfusion using NIRS. 

Methods: A cross-sectional design analytic study was conducted in the PICU of Dr. Sardiito Hospital, Yogyakarta from May to October 2024. The subjects were pediatric patients aged 1 month - <18> Results: Of the 21 PARDS patients, there was no significant difference in CrS02 between the Mild/Moderate PARDS (72.25 + 17.54) and Severe PARDS (65.89 + 19.30) groups, (p=0.440). There was no significant difference in CrS02 between the Temperature group (p=0.485), MAP (p=0.734) or the use of vasopressor (p=0.307). No significant correlation was found between Hb level, cumulative fluid balance, pC02, and pO2 with CrS02 (p>0,05). There was a significant difference in CrS02 between the FTOE groups (p<0>

Concluison: There is no significant relationship between the degree of PARDS and NIRS cerebral perfusion, but there is a significant difference in CrSO2 between FTOE groups.

Kata Kunci : Pediatric Acute Respiratory Distress Syndrome, Near-Infrared Spectroscopy, NIRS cerebral perfusion, Oxygen Index, Fractional Tissue Oxygen Extraction.