Pengaruh Kadar Albumin terhadap Lama Rawatan dan Mortalitas pada Pasien di Ruang Rawat Intensif Anak

Abstract

Background. The use of albumin in the critical care setting is very controversial issue. Low serum albumin concentration in critical illness is associated with a poor outcome. Albumin supplementation remains unclear. The objective of this study is to evaluate the influence of albumin level in critically ill to length of stay and mortality in pediatric intensive care unit Methods. Cross sectional study conducted at Juni – September 2008 in Pediatric Intensive Care Unit Adam Malik hospital. Children at 0-18 years old were taken with purposive sampling. The inclusion criteria were : all patients admitted to PICU with postoperative major surgery and critically ill children. We examined albumin level in first day admitted. Group with hypoalbuminemia (<3 g/dL) were given albumin supplementation according to protocol in PICU. At the end of the care, we calculated how many days patients in PICU or died. Results. We found that group with hypoalbuminemia have average length of stay 7,6 days (9,77) and mortality 12 children (36,4). Group with normal albumin level have 4,7 days (5,00) and mortality 13 children (37,1).There was no significant effect of albumin level to mortality. Type of cases had significant correlation to length of stay and mortality Conclusion. Albumin level did not affect to length of stay and mortality in pediatric intensive care unit

Latar belakang Penggunaan albumin di ruang rawat intensif masih kontroversial. Rendahnya konsentrasi serum albumin pada penyakit kritis berhubungan dengan hasil akhir yang buruk. Manfaat suplementasi albumin pada pasien-pasien di ruang rawat intensif masih belum jelas. Tujuan penelitian ini adalah untuk menilai pengaruh kadar albumin terhadap lama rawatan dan mortalitas di ruang rawat intensif anak Metode Studi cross-sectional dari Juni-September 2008 di ruang rawat intensif anak RS.H.Adam Malik Medan. Anak usia 0-18 tahun dengan pengambilan sampel secara purposive. Kriteria inklusi : semua pasien yang masuk ruang rawat intensif anak yaitu pascapembedahan mayor dan sakit berat. Diperiksa kadar albumin saat masuk. Kelompok hipoalbuminemia (<3 g/dL) mendapat suplementasi albumin berdasarkan protokol di ruang rawat intensif anak. Kelompok albumin normal (≥3 g/dL) tidak diberikan suplementasi. Kemudian diobservasi lama rawatan atau apakah sampel meninggal. Hasil Kelompok hipoalbuminemia rata-rata lama rawatan 7,6 hari (9,77) dan kematian 12 (36,4). Kelompok albumin normal rata-rata lama rawatan 4,7 hari (5,00) dan kematian 13 (37,1). Tidak ada perbedaan yang bermakna antara kedua kelompok terhadap mortalitas. Jenis kasus memiliki hubungan yang bermakna terhadap lama rawatan dan mortalitas. Kesimpulan Kadar albumin tidak berpengaruh terhadap lama rawatan dan mortalitas anak sakit berat di ruang rawat intensif