THE EFFECT OF HYPERTONIC NACL 3% AND MANNITOL 20% THERAPY ON CEREBRAL EDEMA SEVERITY FOR DIFFUSE MODERATE TRAUMATIC BRAIN INJURY
| Main Authors: | Bal'afif, Farhad, Alfandy, Tommy Nazwar, Wardhana, Donny Wisnu, Anindhita, Prisca |
|---|---|
| Format: | Article info application/pdf eJournal |
| Bahasa: | eng |
| Terbitan: |
Universitas Udayana
, 2022
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| Online Access: |
https://ojs.unud.ac.id/index.php/eum/article/view/77648 https://ojs.unud.ac.id/index.php/eum/article/view/77648/46800 |
Daftar Isi:
- ABSTRAK Cedera otak traumatis adalah salah satu alasan utama kematian dan kecacatan dalam kelompok usia efektif. Kasus cedera otak traumatis biasanya ditangani dengan Mannitol dan NaCl hipertonik, namun, beberapa pedoman dan penelitian memiliki hasil yang kontradiktif mengenai cairan yang seharusnya. Sehingga untuk menilai dampak Mannitol 20% dan NaCI hipertonik 3% pada cedera otak sedang difus dengan cedera otak difus. Sebuah studi prospektif dilakukan pada 30 pasien yang dibagi menjadi dua kelompok masing-masing 15 pasien. Kelompok pertama menerima Mannitol 20% (0,5g/kgBB) dan kedua menerima larutan NaCl 3% (5cc/kgBB). Pemantauan cedera kepala diikuti selama 7 hari, penilaian pasien terdiri dari terapi dan gambaran klinis menggunakan Glasgow Coma Scale (GCS) dan kenampakan edema di kepala diperiksa melalui CT scan. Hasil penelitian dianalisis secara statistik menggunakan uji-t, uji regresi linier, dan uji regresi logistik. Terdapat perbedaan bermakna (p = 0,092, 95% CI 0,77, 28,04) antara terapi NaCl 3% dan Mannitol 20%. Ditemukan bahwa pasien yang mendapat terapi NaCl 3% memiliki nilai GCS yang lebih tinggi dibandingkan dengan terapi Mannitol 20% (p = 0,033, 95% CI 1,14, 26,41). NaCl 3% meningkatkan GCS lebih baik daripada Mannitol 20% dengan penyimpangan GCS 2 poin, (p=0,001), NaCl 3% meningkatkan edema serebral 40% lebih baik daripada Mannitol 20% (p=0,001). Secara keseluruhan, penelitian kami menunjukkan bahwa NaCl 3% hipertonik dan Mannitol 20% dapat meningkatkan keparahan edema serebral dan GCS untuk pasien cedera otak traumatis difus. Kata kunci : Cedera otak traumatis, Cerebral edema, GVS, Mannitol 20%, NaCi3%
- ABSTRACT Traumatic brain injury (TBI) is one of the primary reasons of mortality and disabilty withinside the effective age group. TBI cases are usually managed with Mannitol and hypertonic NaCl, however, several guidelines and studies have contradictive result on which fluid should be. This have a look at ambitions to assess the impact of Mannitol 20% and hypertonic NaCI 3% in diffuse moderate brain injury with diffuse brain injury. A prospective study was carried out on 30 patients divided into two groups of 15 patients each. First group received Mannitol 20% (0.5g/kgBW) and second received NaCl 3% solution (5cc/kgBW). Monitoring of the head injury was followed for 7 days, assessment of the patient consisted of therapy and the clinical images represented by Glasgow Coma Scale (GCS) and the edema appearance on the head via CT scan. Result was statistically analyzed using t-test, linier regression tests, and logistic regression test. There was a significant difference (p = 0.092, CI 95% 0.77, 28.04) between NaCl 3% and Mannitol 20% therapy. It was found that patients who received NaCl 3% therapy had a higher GCS value than Mannitol 20% therapy (p = 0.033, CI 95% 1.14, 26,41). NaCl 3 % increase GCS better than Mannitol 20% with GCS deviation 2 points, (p=0.001), NaCl 3% improve cerebral edema 40% better than Mannitol 20% (p=0.001). Overall, our study showed that both hypertonic NaCl 3% and Mannitol 20% can improve cerebral edema severity and GCS for diffuse traumatic brain injury patients. Keywords : Brain injury, Edema Cerebri, GCS, Mannitol 20%, NaCl 3%