Tesis

Kadar natrium serum dan standard base pasca rehidrasi dengan terapi standar atau ringer asetat malat pada anak dengan diare dehidrasi sedang = Blood sodium level and standard base after rehydration with standard tratment or ringer acetate malate in children with diarrhea moderate dehydration

Latar belakang: Hiponatremia merupakan salah satu komplikasi yang sering
terjadi pada anak yang mendapat terapi cairan hipotonik. Hiponatremia sering
ditemui pada diare dengan dehidrasi. Saat ini standar terapi diare dengan dehidrasi
masih menggunakan cairan hipotonik.
Tujuan: Mengetahui perubahan kadar natrium darah dan standard base (SB)
pasca rehidrasi menggunakan cairan standar atau cairan ringer asetat malat(RAM)
Metode: Penelitian uji klinis acak terkontrol membandingkan 2 macam terapi
yaitu cairan standar dan cairan RAM, dilakukan di RSUD Dr. Soetomo Surabaya
Hasil: Didapatkan 21 subyek di kelompok cairan standar dan 19 subyek di
kelompok RAM. Rerata kadar natrium serum dan SB awal di kelompok cairan
standar 140.95 mmol/L dan -10.57 mmol/L, pada kelompok terapi RAM adalah
141.40 mmol/L dan -9.37 mmol/L. Nilai tersebut tidak menunjukan perbedaan
bermakna antara 2 kelompok. Pasca rehidrasi didapatkan kadar natrium 138.31
mmol/L dengan SB 6.32 mmol/L pada kelompok cairan standar dan pada
kelompok RAM 141.74 mmol/L dan -7.37 mmol/L. Perubahan rerata kadar
natrium menunjukkan perbedaan bermakna secara statistik, sedangkan perubahan
SB tidak menunjukkan perbedaan yang bermakna. Rerata penurunan kadar
natrium pada kelompok terapi standar adalah 2.48 mmol/L dan kenaikan 0.37
mmol/L pada kelompok RAM.
Simpulan Didapatkan perubahan kadar natrium darah dan SB pasca rehidrasi
menggunakan 2 cairan berbeda.
Kata kunci: diare dehidrasi sedang, kadar natrium, kadar SB,terapi standar, ringer asetat malat


Background : Hyponatremia is a common complication in children receiving
hypotonic fluid therapy. Hyponatremia is common in diarrhea with dehydration .
The current standard treatment of diarrhea with dehydration still using hypotonic
solutions.
Objective: To determine changes in blood sodium levels and standard base (SB)
after rehydration using standard solutions or Ringer's acetate malate solutions RAM)
Methods: The study was a randomized, controlled clinical trial comparing two
kinds of therapy that is standard solutions and RAM solutions performed at Dr.
Soetomo hospitals
Results: There were 21 subjects in standard group and 19 subjects in groups of
RAM group. The mean initial sodium level and SB in standard treatment were
140.95 mmol /L and -10.57 mmol/L, in the RAM treatment group was 141.40
mmol /L and -9.37 mmol/L. These values did not show significant differences
between the 2 groups. Post rehydration sodium level was 138.31 mmol/L with SB
was -6.32 mmol/L in the standard treatment group and in the group of RAM
141.74 mmol/L and -7.37 mmol/L. Changes in the mean sodium levels showed
statistically significant differences, whereas SB changes showed no significant
difference. The mean decrease in sodium levels in the standard therapy group was
2.48 mmol/L and the mean increase 0.37 mmol/L in the group of RAM.
Conclusions : There were changes in blood sodium levels and SB after
rehydration using two different solutions
Keywords: diarrhea, moderate dehydration, sodium level, standard base level, standard
treatment, ringer acetate malate