PROFIL HEMODINAMIK PASIEN PRAOPERATIF, INTRAOPERATIF, DAN PASCAOPERATIF DENGAN HIPOALBUMIN: SEBUAH SERIAL KASUS
Abstract
Albumin serum (SA) dibutuhkan dalam tubuh sebagai protein yang multifungsi. Peran penting albumin adalah untuk menekan respons inflamasi dalam tubuh dan menjaga permeabilitas vaskuler terutama saat proses inflamasi. Hal ini menjadi perhatian penting bagi pasien yang akan melakukan tindakan operatif untuk menjaga hemodinamik vaskuler. Berikut ini adalah serial kasus mengenai dua pasien dengan diagnosis canal stenosis lumbal dan hernia sikatrikalis. Hasil laboratorium albumin kedua pasien tersebut adalah <3,5 g/dL. Kedua pasien tersebut dipantau kondisi hemodinamik praoperatif, intraoperatif, dan pascaoperatif di Rumah Sakit Daerah dr. Soebandi, Jember, Indonesia. Semua pasien dengan hipoalbuminemia pada penelitian ini mengalami kondisi komorbid hipertensi. Kondisi hemodinamik praoperatif dan pascaoperatif relatif sama, sedangkan saat intraoperatif tekanan darah pasien mengalami penurunan. Albumin memiliki peran dalam mempertahankan permeabilitas vaskuler. Pemeriksaan albumin pada pasien praoperatif penting dilakukan untuk menimbang apakah hemodinamik intraoperatif dan pascaoperatif pasien dapat stabil.
Kata Kunci: heart rate, hipoalbumin, mean arterial pressure (MAP), tekanan darah
References
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11. Padkins, M. et al. Association Between Albumin Level and Mortality Among Cardiac Intensive Care Unit Patients. J. Intensive Care Med. 36, 1475–1482 (2021).
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15. Caironi, P. et al. Albumin Replacement in Patients with Severe Sepsis or Septic Shock. N. Engl. J. Med. 370, 1412–1421 (2014).
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25. Truong, A., Hanna, M. H., Moghadamyeghaneh, Z. & Stamos, M. J. Implications of preoperative hypoalbuminemia in colorectal surgery. World J. Gastrointest. Surg. 8, 353 (2016).
26. Taverna, M., Marie, A. L., Mira, J. P. & Guidet, B. Specific antioxidant properties of human serum albumin. Ann. Intensive Care 3, 1–7 (2013).
2. Chien, S. C. et al. Association of low serum albumin concentration and adverse cardiovascular events in stable coronary heart disease. Int. J. Cardiol. 241, 1–5 (2017).
3. Coombs, A. A. T. & Butterworth, J. F. Guidelines, Practice Parameters, and Consensus Statements in Anesthesiology. Anesth. Analg. 129, 1462–1463 (2019).
4. Sugiartanti, M. F., Oesman, D. & Elfiah, U. Pengaruh Kadar Albumin Serum terhadap Penyembuhan Luka pada Pasien Pascaoperasi Laparotomi dan Lumbotomi di RSD dr. Soebandi Jember. Pustaka Kesehat. 6, 383 (2018).
5. Manolis, A. A., Manolis, T. A., Melita, H., Mikhailidis, D. P. & Manolis, A. S. Low serum albumin: A neglected predictor in patients with cardiovascular disease. Eur. J. Intern. Med. 102, 24–39 (2022).
6. Paar, M. et al. Anticoagulant action of low, physiologic, and high albumin levels in whole blood. PLoS One 12, 1–12 (2017).
7. Ha, C.-E. & Bhagavan, N. V. Novel insights into the pleiotropic effects of human serum albumin in health and disease. Biochim. Biophys. Acta - Gen. Subj. 1830, 5486–5493 (2013).
8. Toyoda, D. et al. Comparison of volume and hemodynamic effects of crystalloid, hydroxyethyl starch, and albumin in patients undergoing major abdominal surgery: A prospective observational study. BMC Anesthesiol. 20, 1–9 (2020).
9. Larson, D. W. et al. Additional Value of Preoperative Albumin for Surgical Risk Stratification among Colorectal Cancer Patients. Ann. Nutr. Metab. 76, 422–430 (2021).
10. Cabrerizo, S. et al. Serum albumin and health in older people: Review and meta analysis. Maturitas 81, 17–27 (2015).
11. Padkins, M. et al. Association Between Albumin Level and Mortality Among Cardiac Intensive Care Unit Patients. J. Intensive Care Med. 36, 1475–1482 (2021).
12. Shannon, C. M. et al. Serum albumin and risks of hospitalization and death: Findings from the Atherosclerosis Risk in Communities study. J. Am. Geriatr. Soc. 69, 2865–2876 (2021).
13. Issangya, C. E. et al. Perioperative serum albumin as a predictor of adverse outcomes in abdominal surgery: Prospective cohort hospital based study in Northern Tanzania. BMC Surg. 20, 4–10 (2020).
14. Tfaily, M. A., Ghanem, P., Farran, S. H., Dabdoub, F. & Kanafani, Z. A. The role of preoperative albumin and white blood cell count in surgical site infections following whipple surgery. Sci. Rep. 12, 1–8 (2022).
15. Caironi, P. et al. Albumin Replacement in Patients with Severe Sepsis or Septic Shock. N. Engl. J. Med. 370, 1412–1421 (2014).
16. Vincent, J. L., De Backer, D. & Wiedermann, C. J. Fluid management in sepsis: The potential beneficial effects of albumin. J. Crit. Care 35, 161–167 (2016).
17. Saugel, B. et al. Mechanisms contributing to hypotension after anesthetic induction with sufentanil, propofol, and rocuronium: a prospective observational study. J. Clin. Monit. Comput. 36, 341–347 (2022).
18. Hofhuizen, C., Lemson, J., Snoeck, M. & Scheffer, G. J. Spinal anesthesia-induced hypotension is caused by a decrease in stroke volume in elderly patients. Local Reg. Anesth. 12, 19–26 (2019).
19. Çakırca, M., Sözen, İ., Bindal, G. T., Baydar, M. & Yastı, A. Ç. Relationship between the albumin level and the anesthesia method and the effect on clinical course in patients with major burns. Ulus. Travma ve Acil Cerrahi Derg. 25, 55–59 (2019).
20. Seidu, S., Kunutsor, S. K. & Khunti, K. Serum albumin, cardiometabolic and other adverse outcomes: systematic review and meta-analyses of 48 published observational cohort studies involving 1,492,237 participants. Scand. Cardiovasc. J. 54, 280–293 (2020).
21. Vlasov, H. et al. Effect and safety of 4% albumin in the treatment of cardiac surgery patients: Study protocol for the randomized, double-blind, clinical ALBICS (ALBumin in Cardiac Surgery) trial. Trials 21, 1–10 (2020).
22. Chappell, D. & Jacob, M. Role of the glycocalyx in fluid management: Small things matter. Best Pract. Res. Clin. Anaesthesiol. 28, 227–234 (2014).
23. Chappell, D. et al. Protection of glycocalyx decreases platelet adhesion after ischaemia/reperfusion: An animal study. Eur. J. Anaesthesiol. 31, 474–481 (2014).
24. Torres, L. N., Sondeen, J. L., Ji, L., Dubick, M. A. & Torres Filho, I. P. Evaluation of resuscitation fluids on endothelial glycocalyx, venular blood flow, and coagulation function after hemorrhagic shock in rats. J. Trauma Acute Care Surg. 75, 759–766 (2013).
25. Truong, A., Hanna, M. H., Moghadamyeghaneh, Z. & Stamos, M. J. Implications of preoperative hypoalbuminemia in colorectal surgery. World J. Gastrointest. Surg. 8, 353 (2016).
26. Taverna, M., Marie, A. L., Mira, J. P. & Guidet, B. Specific antioxidant properties of human serum albumin. Ann. Intensive Care 3, 1–7 (2013).
Published
2024-12-31
How to Cite
GEMAWAN, Taufiq et al.
PROFIL HEMODINAMIK PASIEN PRAOPERATIF, INTRAOPERATIF, DAN PASCAOPERATIF DENGAN HIPOALBUMIN: SEBUAH SERIAL KASUS.
Medika Kartika : Jurnal Kedokteran dan Kesehatan, [S.l.], v. 7, n. 4, p. 432-441, dec. 2024.
ISSN 2655-6537.
Available at: <http://medikakartika.unjani.ac.id/medikakartika/index.php/mk/article/view/607>. Date accessed: 25 jan. 2025.
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