Korelasi Durasi Klem Silang Aorta dengan Peningkatan Kadar Intercellular Adhesion Molecule 1 (ICAM-1) pada Pasien Bedah Jantung Terbuka di RSUP Dr. Sardjito Yogyakarta

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

2025 | Tesis-Subspesialis | SUBSPESIALIS ANESTESIOLOGI DAN TERAPI INTENSIF

Pendahuluan: Penggunaan klem silang aorta pada CPB dapat mengakibatkan cedera iskemia-reperfusi yang memicu respons inflamasi sistemik. ICAM-1 merupakan penanda sensitif disfungsi endotel yang berpotensi meningkatkan komplikasi pasca operasi bedah jantung.

Tujuan:   Mengetahui   hubungan   antara   durasi   klem   silang   aorta   dengan peningkatan kadar ICAM-1 pada pasien bedah jantung terbuka.

Metode: Penelitian kohort prospektif di RSUP Dr. Sardjito Yogyakarta, Maret- April 2025. Sebanyak 34 pasien yang menjalani operasi jantung dengan CPB diikutsertakan.  Kadar  ICAM-1  diukur  sebelum  dan  setelah  penggunaan  klem silang aorta. Analisis menggunakan uji Wilcoxon, korelasi Spearman, dan regresi linear berganda.

Hasil: Subjek penelitian terdiri dari 34 pasien (58,8% perempuan) dengan rerata usia 41,4±14,3 tahun. Jenis operasi terbanyak adalah operasi katup (50%). Rerata durasi klem silang aorta 62,2±30 menit. Terdapat peningkatan signifikan kadar ICAM-1 (p<0 r=0,85; Beta=0,870; p=0,001). r=0,474; p=0,005) r=0,594;>

Kesimpulan: Terdapat korelasi positif kuat dan signifikan antara durasi klem silang aorta dengan peningkatan kadar ICAM-1, yang berhubungan dengan luaran klinis pasca operasi bedah jantung terbuka.

Introduction: The use of aortic cross-clamps during cardiopulmonary bypass (CPB) can cause ischemia-reperfusion injury, triggering a systemic inflammatory response. ICAM-1 is a sensitive marker of endothelial dysfunction that may increase the risk of postoperative complications in cardiac surgery.

Objective: To determine the relationship between aortic cross-clamp duration and increased ICAM-1 levels in patients undergoing open heart surgery.

Methods: A prospective cohort study was  conducted at Dr. Sardjito General Hospital,  Yogyakarta,  from  March  to  April  2025.  A  total  of  34  patients undergoing heart surgery with CPB were included. ICAM-1 levels were measured before  and  after  aortic  cross-clamping.  Analysis  was  performed  using  the Wilcoxon test, Spearman correlation, and multiple linear regression.

Results: The study subjects consisted of 34 patients (58.8?male) with a mean age of 41.4±14.3 years. The most common type of surgery was valve surgery (50%). The average aortic cross-clamp duration was 62.2 ± 30 minutes. There was a significant increase in ICAM-1 levels (p < 0 r  =  Beta=0.870; p=0.001). r=0.474; p=0.005) r=0.594;>

Conclusion: There is a strong and significant positive correlation between the duration of aortic cross-clamping and increased ICAM-1 levels, which is associated with postoperative outcomes following open-heart surgery.

Kata Kunci : Klem silang aorta, ICAM-1, Bedah jantung terbuka, Inflamasi