Tesis

Pengaruh Penurunan Kadar Oksigen dalam Ruangan dengan Timbulnya Gejala Hipoksia dan Nilai Pemeriksaan Gas Darah (Suatu Studi Eksperimental) = The Effects of Declined Oxygen Level with Hypoxia Symptoms and Blood Gases Examination (An Experimental Study).

Latar Belakang Salah satu bentuk kasus kematian dengan mekanisme asfiksia adalah sufokasi dari kondisi lingkungan sekitar (environmental suffocation). Penyebab kematian pada kasus jenis ini tidak dapat ditentukan hanya dari otopsi, sehingga dokter forensik membutuhkan data lingkungan dari tempat kejadian dan gejala hipoksia pada korban. Gejala hipoksia sangat bervariasi, tergantung dari tingkat oksigenasi. Saat ini belum ada penelitian yang menyebutkan angka atau level oksigenasi yang berhubungan dengan environmental suffocation. Salah satu parameter yang digunakan untuk menilai tingkat oksigenasi pada manusia adalah nilai gas darah arteri. Penelitian ini dilakukan untuk mengetahui hubungan (korelasi) antara penurunan kadar oksigen ruangan (chamber) dengan nilai pemeriksaan gas darah dan timbulnya gejala hipoksia. Metode Penelitian ini menggunakan desain studi eksperimental pada hewan model babi (Sus scrofa). Babi diberi perlakuan berupa induksi environmental suffocation, yaitu ditempatkan dalam chamber dengan kadar oksigen 21%, 11% dan 7%. Gejala hipoksia dan nilai pemeriksaan gas darah dinilai pada setiap penurunan kadar oksigen dalam chamber. Hasil Penelitian dilakukan pada bulan September-Oktober 2017 dan didapatkan bahwa gejala hipoksia dan nilai pemeriksaan gas darah arteri berubah seiring dengan penurunan kadar oksigen dalam ruangan. Pada penurunan kadar oksigen ruangan dari 21% ke 11%, frekuensi napas meningkat sebesar 78% dan pada penurunan kadar oksigen ruangan dari 11% ke 7%, frekuensi napas turun sebesar 41%. Pada penurunan kadar oksigen ruangan dari 21% ke 7%, frekuensi nadi meningkat sebesar 41%. Perubahan nilai gas darah pada penurunan kadar oksigen ruangan dari 21% ke 7% adalah pH turun sebesar 0,13%, PO 2 turun sebesar 76%, PCO 2 turun sebesar 7%, HCO 3 turun sebesar 13%, BE (base excess) turun sebesar 66%, dan Saturasi O 2 dalam darah arteri turun sebesar 62%. Kesimpulan Penurunan kadar oksigen ruangan mengakibatkan timbulnya gejala hipoksia berupa perubahan nilai frekuensi napas dan frekuensi nadi, serta perubahan nilai pH, PO 2, PCO 2 , HCO 3, BE, Saturasi O 2 dalam darah arteri. Perubahan tersebut memiliki persentase yang berbeda-beda pada setiap rentang penurunan kadar oksigen ruangan.
Kata Kunci : environmental suffocation, gejala hipoksia, gas darah arteri.


Background Environmental suffocation is a form of asphyxia which is caused by lack of oxygen in the environment. The cause of death in environmental suffocation case can not be determined only from the autopsy, so forensic pathologists need environmental data from the scene and the symptoms of hypoxia from the victim. Symptoms of hypoxia vary widely, depending on the level of oxygen in the air. Until now, there has been no research creating the level of oxygen in the air with environmental suffocation. One of the parameter used to assess the level of oxygenation in humans is the value of arterial blood gas. This study was conducted to determine the correlation between the decreased level of oxygen in the environment with the value of blood gas and the emerge symptoms of hypoxia. Methods This was an experimental study using pig as animal model (Sus scrofa). Pigs were treated with enviromental suffocation induction, which were placed in chamber with 21%, 11% and 7% oxygen levels. Symptoms of hypoxia and the value of arterial blood gas were assessed at each oxygen levels in the chamber. Results Research was conducted from September until October 2017, and found that the symptoms of hypoxia and the value of arterial blood gas changed with the decreased oxygen levels in the chamber. Respiratory frequency increased by 78% following the declination of oxygen level from 21% to 11%, then decreased by 41% after the declination from 11% to 7%. The heart rate increased by 41% following the declination of oxygen level from 21% to 7%. The changes of arterial blood gas values following the declination of oxygen level from 21% to 7% were as follow : pH decreased by 0.13%, PO 2 decreased by 76%, PCO 2 decreased by 7%, HCO 3 decreased by 13%, BE (base excess) decreased by 66 %, and O 2 Saturation in artery decreased by 62%. Conclusion The decreased oxygen levels in the chamber resulted in hypoxia symptoms such as changes in the respiratory rate, hearth rate, also the value of blood gas such as value of pH, PO 2, PCO 2 , HCO 3 , BE, and O 2 Saturation. These changes have different percentages in each range of decreased oxygen levels in the chamber.
Key Words : environmental suffocation, hypoxia symptom, blood gas analysis.