Tesis

Pengaruh Pemberian Lactobacillus Acidophilus Terhadap Gastric Reidual Volume pada Pasien Pasca Operatif Pembedahan Laparotomi Digestif Bawah di Unit Perawatan Intensif = Effect of Lactobacillus Acidophilus Administration on Gastric Residual Volume in Postoperative Lower Digestive Laparotomy Surgery Patients in the Intensive Care Unit.

Latar belakang: Laparotomi merupakan salah satu tindakan pembedahan yang mempengaruhi motilitas gastrointestinal. Penelitian Cihoric et al menunjukkan sebanyak 12,5% pasien pasca laparotomi mengalami komplikasi disfungsi gastrointestinal. Disfungsi pada motilitas gastrointestinal merupakan komplikasi yang sering terjadi pada prosedur pembedahan abdomen. Dari 100 pasien operasi laparotomi digestif, ditemukan sebanyak 40% pasien di ICU mengalami peningkatan gastric residual volume pada pasien pasca operatif laparotomi digestif. Pemberian suplementasi dengan Lactobaciillus acidophilus diketahui dapat meningkatkan motilitas gaster. Tujuan: Penelitian ini bertujuan untuk mengetahui efek hubungan antara pemberian probiotik Lactobacillus acidophillus dengan GRV. Metode: Desain penelitian yang digunakan adalah eksperimental atau uji klinis acak tersamar ganda. Sebanyak 55 subjek yang mengikuti randomisasi, 54 subjek yang akan menjalani operasi laparotomi gastrointestinal dimasukkan ke dalam penelitian, 1 subjek drop out karena sepsis. Subjek penelitian diberikan kapsul probiotik Lactobacillus acidophilus 109 (kelompok probiotik) atau diberikan kapsul laktosa (kelompok plasebo) selama 3 hari sebelum operasi. Kadar GRV diukur 2 hari sesudah prosedur. Hasil: Dari 54 subjek dengan 27 subjek tiap kelompok mengikuti penelitian hingga selesai. Pada hari pertama (24 jam), GRV 24 jam dengan pemberian probiotik dan kelompok kontrol menunjukkan hasil yang tidak signifikan (p value 0,669). Pada hari ke 2 (48 jam), GRV 48 jam dengan pemberian probiotik dan kelompok kontrol menunjukkan hasil yang tidak signifikan (p value 1,000). Hasil yang tidak signifikan pada GRV 24 jam dan 48 jam dapat dipengaruhi faktor perancu yaitu geriatri, riwayat kelainan saraf, obesitas, riwayat penggunaan vasopressor, riwayat konsumsi opioid, hiperkapnia dan hiperglikemia selama di ICU Simpulan: Pemberian probiotik Lactobacillus acidophilus dengan GRV tidak mempunyai efek hubungan dibandingkan dengan placebo.
Kata Kunci: laparotomi, gastrointestinal, probiotik Lactobacillus Acidophilus, GRV, ICU



Background: Laparotomy is a surgical procedure that affects gastrointestinal motility. Research by Cihoric et al showed that 12.5% of post-laparotomy patients experienced complications of gastrointestinal dysfunction. Dysfunction in gastrointestinal motility is a frequent complication of abdominal surgical procedures. Out of 100 patients with digestive laparotomy surgery, it was found that as many as 40% of patients in the ICU experienced an increase in gastric residual volume in postoperative digestive laparotomy patients. Supplementation with Lactobaciillus acidophilus is known to increase gastric motility. Aim: This study aims to determine the effect of the relationship between administration of Lactobacillus acidophillus probiotics and GRV. Methods: The study design used was an experimental or double-blind randomized clinical trial. A total of 55 subjects who followed the randomization, 54 subjects who would undergo gastrointestinal laparotomy were included in the study, 1 subject dropped out due to sepsis. Research subjects were given probiotic capsules Lactobacillus acidophilus 109 (probiotic group) or given lactose capsules (placebo group) for 3 days before surgery. GRV levels were measured 2 days after the procedure. Results: Of the 54 subjects with 27 subjects in each group, they followed the research to completion. On the first day (24 hours), the 24-hour GRV with the administration of probiotics and the control group showed insignificant results (p value 0.669). On day 2 (48 hours), GRV 48 hours with probiotic administration and the control group showed insignificant results (p value 1,000). Results that were not significant at GRV 24 hours and 48 hours could be influenced by confounding factors, geriatrics, history of neurological disorders, obesity, history of vasopressor use, history of consumption of opioids, hypercapnia and hyperglycemia while in the ICU Conclusion: Administration ofLactobacillus Acidophilus probiotics with GRV had no association effect compared to placebo.
Keywords: laparotomy, gastrointestinal, probiotic Lactobacillus Acidophilus, GRV, ICU