Glycemia Control Pada Pasien Paska Pembedahan Jantung: Studi Kasus

Ismail Fahmi, Elly Nurachmah, Tuti Herawati

Abstract


ABSTRAK


Cardiac surgery-associated acute kidney injury (CSA-AKI) merupakan komplikasi utama dari pembedahan jantung. Salah satu kondisi yang dapat menyebabkan terjadinya CSA-AKI pada pasien bedah jantung adalah ketidakstabilan kadar glukosa darah. Protokol Enhanced Recovery After Surgery (ERAS) memaparkan pentingnya glycemia control untuk mencegah komplikasi terjadinya CSA-AKI. Artikel ini merupakan studi kasus yang menggambarkan manajemen keperawatan : glycemic control untuk mencegah terjadinya CSA-AKI pada pasien bedah jantung. Setelah dilakukan intervensi keperawatan berupa glycemia control, pasien tidak mengalami CSA-AKI. Manajemen gula darah pada melalui manajemen diet dan kolaborasi manajemen insulin merupakan rekomendasi ERAS dalam mencegah CSA-AKI pada pasien pembedahan jantung.

 

 

ABSTRACT

Cardiac surgery-associated acute kidney injury (CSA-AKI) is a major complication of heart surgery. One of the conditions that can cause CSA-AKI in cardiac surgery patients is the instability of blood glucose levels. The Enhanced Recovery After Surgery (ERAS) protocol explains the importance of glycemic control to prevent complications from CSA-AKI. This article is a case study describing nursing management: glycemic control to prevent CSA-AKI in cardiac surgery patients. After the nursing intervention in the form of glycemia control, the patient did not experience CSA-AKI. Blood sugar management through diet management and insulin management collaboration is ERAS recommendations in preventing CSA-AKI in cardiac surgery patients.


Keywords


Acute kidney injury (AKI); perioperatif; ERAS; Glycemic control; cardiac surgery

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References


Elizabeth. (2011). Perioperative Hyperglycemia Management: An Update. Physiology & Behavior, 176(1), 139–148. https://doi.org/10.1016/j.physbeh.2017.03.040

Engelman, D. T., Ben Ali, W., Williams, J. B., Perrault, L. P., Reddy, V. S., Arora, R. C., … Boyle, E. M. (2019). Guidelines for Perioperative Care in Cardiac Surgery: Enhanced Recovery after Surgery Society Recommendations. JAMA Surgery, 154(8), 755–766. https://doi.org/10.1001/jamasurg.2019.1153

Giannini, F., Latib, A., Jabbour, R. J., Ruparelia, N., Aurelio, A., Ancona, M. B., … Colombo, A. (2016). Impact of post-procedural hyperglycemia on acute kidney injury after transcatheter aortic valve implantation. International Journal of

Cardiology, 221, 892–897. https://doi.org/10.1016/j.ijcard.2016.07.029

Lazar, H. L. (2012). Glycemic Control during Coronary Artery Bypass Graft

Surgery. ISRN Cardiology, 2012, 1–14. https://doi.org/10.5402/2012/292490

Lazar, H. L., McDonnell, M. M., Chipkin, S., Fitzgerald, C., Bliss, C., & Cabral, H. (2011). Effects of aggressive versus moderate glycemic control on clinical outcomes in diabetic coronary artery bypass graft patients. Annals of Surgery, 254(3), 458–464. https://doi.org/10.1097/SLA.0b013e31822c5d78

Leininger, S. (2018). Blood Glucose Management for reducing cardiac surgery infections. Critical Care Nursing Quarterly, 41(4), 399–406. https://doi.org/10.1097/CNQ.0000000000000227

Levy, J. H., Lobdell, K., Fletcher, N., Kirsch, M., Nelson, G., Engelman, R. M., … Boyle, E. M. (2019). Guidelines for Perioperative Care in Cardiac Surgery Enhanced Recovery After Surgery Society Recommendations, 154(8), 755–766. https://doi.org/10.1001/jamasurg.2019.1153

Mathew, J., Raghavan, R., Kamath, G., Kamath, A., Velladath, S., Nalini, K., & Gopalakrishna, K. (2014). Acute kidney injury in post cardiac surgery - An evaluation with eGFR ( Estimated glomerular filtration rate ) and akin Criteria. WebMedCentral, 1–11.

Oezkur, M., Wagner, M., Weismann, D., Krannich, J. H., Schimmer, C., Riegler, C., … Heuschmann, P. U. (2015). Chronic hyperglycemia is associated with acute kidney injury in patients undergoing CABG surgery - a cohort study. BMC Cardiovascular Disorders, 15(1), 4–9. https://doi.org/10.1186/s12872-015-0028-y

Ortega-Loubon, C., Fernández-Molina, M., Carrascal-Hinojal, Y., & Fulquet-Carreras, E. (2016). Cardiac surgery-associated acute kidney injury. Annals of Cardiac Anaesthesia, 19(4), 687–698. https://doi.org/10.4103/0971-9784.191578

Patschan, D., & Müller, G. A. (2016). Acute Kidney Injury in Diabetes Mellitus. International Journal of Nephrology, 2016. https://doi.org/10.1155/2016/6232909

Reet V An Den, G., Erghe, B., Harles, C., Erwaest, V., Rans, F., Ruyninckx, B., … Ouillon, B. (2001). The New England Journal of Medicine INTENSIVE INSULIN THERAPY IN CRITICALLY ILL PATIENTS A BSTRACT Background Hyperglycemia and insulin resistance. New England Journal of Medicine, 345(19), 1359–1367. Retrieved from www.nejm.org

Sutton, T. A., Fisher, C. J., & Molitoris, B. A. (2002). Microvascular endothelial injury and dysfunction during ischemic acute renal failure. Kidney International, 62(5), 1539–1549. https://doi.org/10.1046/j.1523-1755.2002.00631.x

Zhang, X., Yan, X., Gorman, J., Hoffman, S. N., Zhang, L., & Boscarino, J. A. (2014). Perioperative hyperglycemia is associated with postoperative neurocognitive disorders after cardiac surgery. Neuropsychiatric disease and treatment, 10, 361.




DOI: https://doi.org/10.17509/jpki.v6i2.28745

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