Pengaruh Pemberian Profilaksis Heparin terhadap Kejadian Trombosis dengan Menilai Kadar D-Dimer dan Fibrinogen pada Pasien Sepsis di ICU

Abstract

Background: Heparin is a thromboprophylactic agent that is often used in ICU patients. Thrombosis in critically ill patients, especially sepsis, requires special attention both from a medical and economic perspective due to the large health costs incurred. Approximately 10-33% of all hospitalized patients suffer from thrombosis and more than 10% of these patients are critically ill patients in the ICU. Heparin has been widely used as therapy and primary prophylaxis against the occurrence of thrombosis, both in ordinary conditions and in critical conditions according to the recommendations of the American College of Chest Physicians. Previous studies have shown that the use of thromboprophylaxis in ICU patients affects patient clinical outcomes, such as mortality and length of stay. Therefore, researchers are interested in conducting research so that the data and results of the study can be used in considering the administration of Heparin as a prevention of thrombosis in septic patients treated in the ICU. Methods: The design of this study used a one group only pretest-posttest design, to prove the effect of heparin on D-dimer and fibrinogen levels in septic patients in the ICU. Results: In this study, the mean age of the sample was 51.26 ± 12.42 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 129.13 ± 15.24 and 82.30 ± 10.85, respectively. The level of d-dimer before and after intravenous heparin administration was obtained p value of 0.001 < 0.05, which indicates a significant effect between D-Dimer Day 1 and D-Dimer Day 3 after heparin administration. Fibrinogen levels before and after intravenous heparin administration showed a P value of 0.043 < 0.05, so there was a significant effect between Day 1 Fibrinogen and Day 3 Fibrinogen after heparin administration. Conclusion: There is an effect of heparin on the incidence of thrombosis by assessing the levels of D-dimer and fibrinogen in septic patients in the ICU.