Perbedaan Nilai Near Infrared Spectroscopic terhadap Posisi Head Up 15o dan Head Up 30 O pada Pasien yang Dirawat di Ruang Intensive Care Unit

Abstract

Background: Cerebral oxygenation is strongly influenced by cerebral autoregulation which can regulate blood flow to the brain, causing oxygen intake to increase or decrease. Posture changes during anesthesia have complex effects on the systemic and cerebral circulation that have the potential to decrease cerebral blood flow and oxygenation. In a conscious individual, the change from supine to standing rapidly activates neuroendocrine reflexes that regulate blood pressure and maintain adequate cerebral perfusion. Significant physiological changes occur when the anesthetized patient is tilted from the supine to the upright position. Decreased venous return results in significant decreases in cardiac output, systemic vascular resistance, and arterial pressure. Cerebral autoregulation responds simultaneously with cerebral vasodilation that regulates CBF. Cerebral vasculature is richly innervated by adrenergic nerve fibers and the activity of extracranial sympathetic nerve intrinsically linked to baroreceptor function, that may influence CBF. Therefore, researchers are interested in examining the comparison of near-infrared spectroscopy (NIRS) values to the head-up position 15° and 30o in patients treated in the ICU of H Adam Malik Hospital, Medan. Method: Analytical study design with experimental design to know differences in NIRS values in various head-up positions in patients treated at the ICU H. Adam Malik Hospital, Medan. Results: In this study, the mean age of the sample was 53.45 ± 14.44 years, and the average body mass index of the sample was 23.92 ± 2.18 kg/m2. The systolic and diastolic blood pressure of the study sample was found to be 122.68 ± 17.76 and 73.50 ± 10.25, respectively. NIRS Head Up values 15° and 30° on the left, the mean NIRS value was 56.27 ± 13.32 and 65.45 ± 15.14, the P value was 0.01 < 0.05, so there was a significant difference between Head Up 15° and 30°. Conclusion: There is a difference in the value of near-infrared spectroscopy (NIRS) between Head Up 15° and 30°. in patients treated in the ICU.