Tesis

Luaran Pasien Pneumonia COVID-19 Dengan Acute Respiratory Distress Syndrome Berdasarkan Kriteria Berlin Di RSUP Persahabatan Jakarta = Berlin definition of acute respiratory distress syndrome and outcome in pneumonia COVID-19 patient at Persahabatan hospital.

Latar belakang: Manifestasi klinis COVID-19 yang berat adalah pneumonia berat, acute respiratory distress syndrome (ARDS), sepsis dan syok septik. ARDS berkembang pada 42% pasien dengan pneumonia COVID-19 dan 61 – 81% pasien yang membutuhkan perawatan ICU. Penting sejak awal pasien dirawat di RS untuk memantau gejala dan keluhan apakah pasien akan mengalami ARDS ketika terinfeksi COVID-19 dan memburuk. Tujuan penelitian: Mengetahui gambaran karakteristik dan luaran pasien COVID-19 dengan ARDS berdasarkan kriteria Berlin di RSUP Persahabatan. Metode penelitian: Analisis observasional kohort retrospektif terhadap pasien COVID-19 terkonfirmasi yang di rawat di RSUP Persahabatan secara total sampling dari bulan Oktober sampai dengan November 2020. Kami meninjau 50 rekam medis pasien terkonfirmasi yang memenuhi kriteria inklusi. Hasil penelitian: Kelompok usia terbanyak pada penilitian kami adalah kelompok usia < 50 tahun dengan rerata usia subjek penelitian adalah 52,56 tahun, didominasi oleh laki-laki sebanyak 78%.60% pasien memiliki status gizi normal. Derajat ARDS paling banyak adalah berat sebesar 38%. Komorbid subjek penelitian terbanyak adalah hipertensi sebanyak 38,46%, kedua DM tipe 2 sebanyak 25,64%, ketiga penyakit hipertensi dan DM tipe 2 sebanyak 17,95%. Subjek yang mempunyai komorbid sebanyak 78% dari total subjek. 78% subjek memiliki gambaran foto toraks infiltrate bilateral. 44% subjek menggunakan alat bantu napas berupa ventilator 40%. Pasien yang meinggal dari subjek penelitian sebanyak 20 orang (40%), yang lainnya bertahan hidup sebanyak 40 orang (60%). Terdapat perbedaan bermakna secara statistik antara derajat ARDS terhadap luaran dengan nilai p 0,007 Kesimpulan: Terdapat perbedaan yang berkmakna antara derajat klinis ARDS berdasarkan kriteria Berlin terhadap luaran
Kata kunci: Coronavirus disease 2019, Acute Respiratory Distress Syndrome, Kriteria Berlin


Backgrounds: Severe clinical manifestation of COVID-19 are pneumonia, acute respiratory distress syndrome (ARDS), sepsis, and septic shock. ARDS develops in 42% patients with COVID-19 and 61-81% of patients requiring ICU care. It is important that COVID-19 patient being admitted to the hospital for monitoring symptom and predicting ARDS to prevent worsening and poor outcome. Aims: to know the characteristic and confirmed COVID-19 patients‟ with ARDS outcome in Persahabatan hospital Jakarta. Methods: We performed observational retrospective cohort analysis of confirmed COVID-19 patients hospitalized in Persahataban hospital. Subjects by means of total sampling were confirmed COVID-19 patients between October till November 2020. We reviewed the medical record of 50 patients whom met the inclusion criteria. Results: Mean age of patients in this study were 52,56 years old, dominated by males (78%) and group age of < 50 year. Most of the patients were with severe ARDS (38%) and presented with comorbidity (78%). Hypertension was the most frequent comorbidity, second was diabetic mellitus.78% subject has bilateral infiltrate and 44% subject using invasive ventilator Death patients were 20 (40%). There were an association between ARDS with patients outcome (p < 0,007). Conclusions: Severity of ARDS were associated with confirmed COVID-19 patients‟ outcome in Persahabatan hospital
Keywords: Coronavirus disease 2019, Acute Respiratory Distress Syndrome, Berlin criteria