Penerapan Posisi Passive Leg Raising Dalam Peningkatan Tekanan Darah Pada Pasien Syok Sepsis Di IGD
DOI:
https://doi.org/10.57214/jasira.v2i2.63Keywords:
Septic Shock, Blood Pressure, Passive Leg RaisingAbstract
Background: Sepsis is characterized by the body's excessive inflammatory response to infection, potentially leading to life-threatening organ dysfunction. Additionally, sepsis can induce hypotension involving both pro-inflammatory and anti-inflammatory body responses. One non-pharmacological intervention for hypotension is Passive Leg Raising (PLR), where the patient lies flat while the legs are raised at a 45-degree angle. Objective: To determinethe effect of increasing blood pressure in septic shock patients after PLR therapy. Methods: A case study conducted on May 12, 2024, at the Emergency Room of PKU Muhammadiyah Yogyakarta, observed patients blood pressure and mean arterial pressure (MAP) every 30 minutes over 1 hour using bedside monitoring before and 30 minutes after vasopressor administration. Results: PLR for 60 minutes increased systolic blood pressure by 8mmHg, diastolic by 7mmHg, and MAP by 8mmHg. Subsequent vasopressor addition for 30 minutes yielded more significant increases: systolic blood pressure rose by 35mmHg, diastolic by 26mmHg, and MAP by 37mmHg. Conclusion: PLR administration increases blood pressure, but combining it with vasopressors proves more effective in septic shock management.
References
Akanbi, O. O., Onilede, D. A., Olakulehin, O. A., Habeeb, O. G., Olanipekun, O. O., Akinloye, T. A., & Yunusa, Y. A. (2023). Evaluation of passive leg raising test for predicting fluid responsiveness in shock patients. Western Nigeria Journal of Medical Sciences, 6(1), 49-55.
Angelia, S., & Panduwiguna, I. (2024). Dampak Ketepatan Waktu Terapi Antibiotik pada Hasil Pasien Dengan Sepsis dan Syok Septik. JKM (Jurnal Kesehatan Masyarakat) Cendekia Utama, 12(1), 107-121.
Azadian, M., Win, S., Abdipour, A., Kim, C. K., & Nguyen, H. B. (2022). Mortality benefit from the passive leg raise maneuver in guiding resuscitation of septic shock patients: a systematic review and meta-analysis of randomized trials. Journal of Intensive Care Medicine, 37(5), 611-617. https://doi.org/10.1177/08850666211019713
Douglas, I. S., Alapat, P. M., Corl, K. A., Exline, M. C., Forni, L. G., Holder, A. L., Kaufman, D. A., Khan, A., Levy, M. M., Martin, G. S., Sahatjian, J. A., Seeley, E., Self, W. H., Weingarten, J. A., Williams, M., & Hansell, D. M. (2020). Fluid Response Evaluation in Sepsis Hypotension and Shock: A Randomized Clinical Trial. Chest, 158(4), 1431–1445. https://doi.org/10.1016/j.chest.2020.04.025
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., ... & Levy, M. (2021). Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Critical care medicine, 49(11), e1063-e1143.
Fleischmann-Struzek, C., & Rudd, K. (2023). Challenges of assessing the burden of sepsis. Medizinische Klinik-Intensivmedizin und Notfallmedizin, 118(Suppl 2), 68-74. https://doi.org/10.1007/s00063-023-01088-7
Font, M. D., Thyagarajan, B., & Khanna, A. K. (2020). Sepsis and Septic Shock–Basics of diagnosis, pathophysiology and clinical decision making. Medical Clinics, 104(4), 573-585. https://doi.org/10.1016/j.mcna.2020.02.011
Harahap, H. M., Nasution, D. S. M., Munandar, F., Siregar, N. F., & Nainggolan, R. R. S. (2021). Sepsis: Kriteria Diagnosa Dan Tatalaksana. Jurnal Implementa Husada, 2(3), 305-320.
Irvan, I., Febyan, F., & Suparto, S. (2018). Sepsis dan tata laksana berdasar guideline terbaru. JAI (Jurnal Anestesiologi Indonesia), 10(1), 62-73. https://doi.org/10.14710/jai.v10i1.20715.
Kalra, A., Bansal, S., & Malik, V. (2020). Evaluation of Changes in Mean Arterial Pressure and Pulse Pressure Following Passive Leg Rising Test as Index and Predictor of Fluid Responsiveness in Septic Shock Patients. Journal of Cardiovascular Disease Research, 11(09).
Kusnawan, I. M. D. (2023). Problem Diagnosis dan Tatalaksana Pasien Syok Sepsis dengan Meningitis Suis. Jurnal Medika Hutama, 5(01 Oktober), 3610-3636. Retrieved from https://jurnalmedikahutama.com/index.php/JMH/article/view/681
Mallat, J., Fischer, M. O., Granier, M., Vinsonneau, C., Jonard, M., Mahjoub, Y., ... & Guinot, P. G. (2022). Passive leg raising-induced changes in pulse pressure variation to assess fluid responsiveness in mechanically ventilated patients: a multicentre prospective observational study. British Journal of Anaesthesia, 129(3), 308-316. https://doi.org/10.1016/j.bja.2022.04.031
Moore, C. C., Jacob, S. T., Banura, P., Zhang, J., Stroup, S., Boulware, D. R., ... & Liu, J. (2019). Etiology of sepsis in Uganda using a quantitative polymerase chain reaction-based TaqMan array card. Clinical Infectious Diseases, 68(2), 266-272. https://doi.org/10.1093/cid/ciy472
Pranskunas, A., Gulbinaite, E., Navickaite, A., & Pranskuniene, Z. (2023). Differences in Hemodynamic Response to Passive Leg Raising Tests during the Day in Healthy Individuals: The Question of Normovolemia. Life, 13(7), 1606. https://doi.org/10.3390/life13071606
Rudd, K. E., Johnson, S. C., Agesa, K. M., Shackelford, K. A., Tsoi, D., Kievlan, D. R., ... & Naghavi, M. (2020). Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. The Lancet, 395(10219), 200-211. https://doi.org/10.1016/S0140-6736(19)32989-7
Suprapto Putra, I. A. (2019). Update Tatalaksana Sepsis. Cermin Dunia Kedokteran, 46(11), 681–685. https://doi.org/10.55175/cdk.v46i11.408
Tobin, M. J. (2021). The criteria used to justify endotracheal intubation of patients with COVID-19 are worrisome. Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 68, 258-259. https://doi.org/10.1007/s12630-020-01853-8
Toppen, W., Aquije Montoya, E., Ong, S., Markovic, D., Kao, Y., Xu, X., ... & Barjaktarevic, I. (2020). Passive leg raise: feasibility and safety of the maneuver in patients with undifferentiated shock. Journal of intensive care medicine, 35(10), 1123-1128. https://doi.org/10.1177/0885066618820492
Yi-Min, X., Mei-Qi, C., Ting-Feng, H., Chen, M., Chen, Q., & Chen, F. (2021). Predictive value of continuous non-invasive arterial pressure monitor combined with passive leg raising test for volume responsiveness assessment in patients with septic shock. Jie Fang Jun Yi Xue Za Zhi, 46(11), 1112-1117. doi:https://doi.org/10.11855/j.issn.0577-7402.2021.11.08
Yunus, P., Damansyah, H., & Ibrahim, I. (2023). Penerapan Terapi Posisi Passive Leg Raising dalam Meningkatkan Tekanan Darah pada Pasien Syok Hipovolemik di Ruangan Igd Rsud Prof. Dr. H. Aloei Saboe Kota Gorontalo. Medical Jurnal of Al-Qodiri, 8(2), 117-122.
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