Perbandingan Pengukuran Stroke Volume Variation dan Cardiac Output pada Passive Leg Raising Menggunakan Non-Invasive Cardiometer (Icon®) dan Pressure Recording Analytic Method (Most-Care®) pada Pasien Syok Sepsis di ICU RSUP Dr. Sardjito Yogyakarta

Andryadi Wijaya, DR. dr. Yusmein Uyun, SpAn-TI, Subsp.An.O(K).; dr. Calcarina Fitriani Retno Wisudarti, SpAn-TI, Subsp.TI(K)

2025 | Tesis-Subspesialis | SUBSPESIALIS ANESTESIOLOGI DAN TERAPI INTENSIF

Latar belakang: Resusitasi cairan merupakan lini pertama tatalaksana syok sepsis. Uji PLR bertujuan menilai responsivitas cairan. SVV dan CO merupakan paramater fluid responsiveness ditandai adanya peningkatan CO sebesar 10-15%. Modalitas standar baku emas pengukuran SVV dan CO adalah pulmonary artery catheter. Modalitas lain bersifat minimal invasif dan non invasif, yaitu MostCare® dan ICON®. Sejauh melakukan telaah literatur, peneliti tidak menemukan penelitian perbandingan SVV dan CO pada uji PLR menggunakan MostCare® dan ICON® pada pasien syok sepsis di ICU RSUP Dr. Sardjito Yogyakarta.

Tujuan: Mengetahui perbandingan SVV dan CO pada uji PLR menggunakan MostCare® dan ICON® terhadap pasien syok sepsis di ICU RSUP Dr. Sardjito Yogyakarta.

Metode: Penelitian ini adalah analitik observasional dengan pendekatan potong lintang. Dilakukan di ICU RSUP Dr. Sardjito Yogyakarta pada bulan Januari–Mei 2025. Data SVV dan CO dihitung mean dan standar deviasi. Selanjutnya dilakukan uji T berpasangan dan interclass coefficient correlation (ICC).

Hasil: Subjek pada penelitian ini sebanyak 29 pasien. Pengukuran SVV (p=0,702; ICC=0.845), CO (p=0,103; ICC=0.826) pre PLR menggunakan MostCare® dan ICON® dan pengukuran SVV (p=0,109; ICC=0.776), CO (p=0,645; ICC=0.874) post PLR menggunakan MostCare® dan ICON® sebanding keduanya dengan kesesuaian yang baik.

Kesimpulan: Pengukuran SVV dan CO pada uji PLR antara MostCare® dan ICON® tidak ada perbedaan rerata yang signifikan dan memiliki nilai ICC yang baik.

Background: Fluid resuscitation is the first-line treatment for septic shock. The PLR test aims to assess fluid responsiveness. SVV and CO are fluid responsiveness parameters which marked an increase 10-15% of CO. Gold standard for measuring SVV and CO is pulmonary artery catheter. Other modalities include MostCare® and ICON®. A literature review did not find any comparative studies comparing SVV and CO in the PLR test using MostCare® and ICON® in septic shock at the ICU of Dr. Sardjito Hospital, Yogyakarta.

Objective: To determine the comparison of SVV and CO in the PLR test using MostCare® and ICON® in septic shock patients at the ICU of Dr. Sardjito Hospital, Yogyakarta.

Methods: This was an observational analytical study with cross-sectional approach. It was conducted at the ICU of Dr.Sardjito Hospital from January to May 2025. The mean and standard deviation of SVV and CO data were calculated. Paired T-test and interclass correlation coefficient (ICC) were performed. 

Results: This study included 29 subjects. Pre-PLR SVV (p=0.702; ICC=0.845), CO (p=0.103; ICC=0.826) measurements using MostCare® and ICON®, and post- PLR SVV (p=0.109; ICC=0.776), CO (p=0.645; ICC=0.874) measurements using MostCare® and ICON® were comparable with good agreement.

Conclusion: There was no significant difference in mean values for SVV and CO between MostCare® and ICON® on PLR, and the ICC values were good.

Kata Kunci : SVV, CO, ICON®, MostCare®, syok sepsis