MANAJEMEN PENCEGAHAN PENINGKATAN TEKANAN INTRAKRANIAL (TIK) PADA PASIEN PASCA KRANIOTOMI DI RUANG INTENSIVE CARE UNIT (ICU)

INTRACRANIAL PRESSURE MANAGEMENT OF POST CRANIOTOMY PATIENT IN INTENSIVE CARE UNIT (ICU)

  • Ahmat Pujianto 1Jurusan Keperawatan, Universitas Borneo Tarakan, Kota Tarakan, Kalimantan Utara, Indonesia
  • Hendy Lesmana 1Jurusan Keperawatan, Universitas Borneo Tarakan, Kota Tarakan, Kalimantan Utara, Indonesia
  • Maria Imaculata Ose 1Jurusan Keperawatan, Universitas Borneo Tarakan, Kota Tarakan, Kalimantan Utara, Indonesia
  • Bayu Purnomo Rumah Sakit Umum Daerah dr. H. Jusuf SK, Kota Tarakan, Kalimantan Utara, Indonesia
  • Aris Junaidi Jurusan Keperawatan, Universitas Borneo Tarakan, Kota Tarakan, Kalimantan Utara, Indonesi

Abstract

Kondisi pasien pasca kraniotomi relatif tidak stabil, dan berpotensi mengalami komplikasi intrakranial sehingga pasien harus mendapat pemantauan ketat di ruang perawatan intensif (Intensive Care Unit ((ICU). Penelitian ini bertujuan untuk mendapatkan gambaran manajemen pencegahan tekanan intrakranial (TIK) pada pasien pasca kraniotomi di ICU. Penelitian ini merupakan penelitian studi kasus yang melibatkan 12 responden pasien pasca kraniotomi sesuai kriteria inklusi dan eksklusi. Instrumen yang digunakan untuk mengumpulkan data adalah lembar observasi catatan medis pasien yang berisi karakteristik responden, status hemodinamik responden, manajemen TIK yang dilakukan, nilai pemeriksaan Glasgow Coma Scale-Pupil (GCS-P), nilai laboratorium untuk laktat, dan nilai elektrolit (natrium, kalium, dan klorida). Hasil penelitian menunjukkan bahwa pada hari ketiga perawatan, pengaruh sedasi sudah menurun dan 3 responden (8,3%) sudah dalam keadaan sadar dengan nilai GCS-P E4M6Vett-P 3/3. Semua responden diberikan posisi head up 15-30 derajat, sedangkan untuk mode ventilator mekanik, positive end expiratory pressure (PEEP), fraksi oksigen, obat sedasi, analgesik. Pada hari ketiga perawatan, sebagian besar responden sudah mengalami peningkatan ke arah perbaikan. Manajemen pencegahan peningkatan tekanan intrakranial pada pasien pasca kraniotomi akibat cedera otak traumatik pada pasien di ICU sesuai dengan pedoman Brain Trauma Foundation Guideline tahun 2016. Hanya saja untuk pengukuran tekanan intrakranial pada semua pasien belum dilakukan baik secara non-invasif maupun invasif.


Kata kunci: ICU, manajemen TIK, pasca kraniotomi


DOI : 10.35990/mk.v6n1.p44-55

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Published
2023-03-31
How to Cite
PUJIANTO, Ahmat et al. MANAJEMEN PENCEGAHAN PENINGKATAN TEKANAN INTRAKRANIAL (TIK) PADA PASIEN PASCA KRANIOTOMI DI RUANG INTENSIVE CARE UNIT (ICU). Medika Kartika : Jurnal Kedokteran dan Kesehatan, [S.l.], v. 6, n. 1, p. 44-55, mar. 2023. ISSN 2655-6537. Available at: <http://medikakartika.unjani.ac.id/medikakartika/index.php/mk/article/view/374>. Date accessed: 29 mar. 2024.