Pengaruh Pemberian Ca Glukonas terhadap Kadar Kalium Pasien Post Transfusi Packed Red Cell (Prc) pada Lama Darah Simpan > 3 Hari di Rsup Haji Adam Malik Medan

Abstract

Background : Blood transfusion is an important and routine medical treatment, especially in cases that require surgery such as trauma. One of the biochemical changes that occur in PRC due to erythrocyte storage is an increase in potassium levels in PRC plasma. Hyperkalemia is the most common complication of stored blood transfusion. Cardiac arrest has been widely reported in transfusion-associated hyperkalemia. Methods : This study used a pre-experimental study with a pretest-posttest group design to determine the effect of giving Ca gluconate on blood potassium levels in patients receiving packed red cell (PRC) blood transfusions with a shelf life of > 3 days at Haji Adam Malik General Hospital Medan. Results : The distribution of sample characteristics in this study has a mean age of 46 ± 13.63. Based on gender, the distribution of male was 7 (22.6%) and female was 24 (77.4%), with a BMI value of 23.28 ± 6.44. Based on the hemodynamic picture, the mean systolic was 105.87 ± 20.59, diastolic was 70.41 ± 11.94, RR was 23.06 ± 2.39 and MAP was 83.31 ± 14.48. The potassium value before administration of Ca gluconate with blood shelf life < 3 days, the mean value of potassium was 5.84 ± 0.89, and the potassium value after administration of Ca gluconate with blood shelf life < 3 days, the mean value of potassium was 5.43 ± 0 ,90. it can be seen that there is an insignificant change in potassiumlevels before and after administration of Ca gluconate where the average potassium level before administration of Ca gluconate is above 5.5, whereas after administration of Ca gluconate there is no significant change in all samples. Conclusions : There is an effect of giving Ca gluconate on the potassium level of post transfusion Packed red cell (PRC) patients on blood storage > 3 days at Haji Adam Malik General Hospital Medan.

Latar belakang : Tindakan transfusi darah merupakan salah satu tatalaksana medis penting dan rutin dilakukan, terutama pada kasus yang membutuhkan tindakan operatif seperti trauma. Perubahan biokimia yang terjadi pada PRC akibat penyimpanan eritrosit salah satunya adalah peningkatan kadar kalium pada plasma PRC. Hiperkalemia merupakan komplikasi tersering pada transfusi darah simpan. Henti jantung telah banyak dilaporkan pada transfusi yang berhubungan dengan hiperkalemia. Metode: Penelitian ini mengunakan studi pre eksprimental dengan desain pretest-posttest group untuk mengetahui efek pemberian Ca glukonas terhadap kadar kalium darah pada pasien yang menerima transfusi darah jenis packed red cell (PRC) dengan lama simpan > 3 hari di RSUP Haji Adam Malik Medan. Hasil : distribusi karakteristik sampel pada penelitian ini memiliki rerata usia 46 ± 13,63. Berdasarkan jenis kelamin didapatkan distribusi laki laki sebesar 7 (22,6%) dan perempuan 24 (77,4%), dengan nilai BMI 23,28 ± 6,44. Berdasarkan gambaran hemodinamik di dapatkan rerata sistolik 105,87 ± 20,59, Diastolik 70,41 ± 11,94, RR 23,06 ± 2,39 danMAP 83,31 ± 14,48. Nilai kaliumsebelumpemberian Ca glukonas dengan lama simpan darah < 3 hari didapatkan nilai rerata kalium sebesar 5,84 ± 0,89, dan nilai kalium setelah pemberian Ca glukonas dengan lama simpan darah < 3 hari didapatkan nilai rerata kalium sebesar 5,43 ± 0,90. dapat dilihat bahwa terdapat perubahan yang tidak signifikan pada kadar kalium sebelum dan sesudah pemberian Ca glukonas dimana rata rata kadar kalium sebelum pemberian Ca glukonas diatas 5,5, sedangkan setelah pemberian Ca glukonas tidak terjadi perubahan yang signifikan pada semua sampel. Kesimpulan: Terdapat pengaruh pemberian Ca glukonas terhadap kadar kalium pasien post transfusi Packed red cell (PRC) pada lama darah simpan > 3 hari di RSUP Haji Adam Malik Medan.