Description of Cerebral Oxygenation Measures after One Hour Bundle in the Treatment of Sepsis Patients in Adam Malik Haji General Hospital, Medan

Authors : Alpert Davista; Akhyar Hamonangan Nasution; Bastian Lubis

Volume/Issue : Volume 6 - 2021, Issue 10 - October

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Sepsis is an organ dysfunction because of impaired regulation of the body's response to infection. In non-cardiac ICU cases, sepsis is the second leading cause of mortality. Because of the high mortality of sepsis, the Surviving Sepsis Campaign (SSC) updated the management of sepsis with the latest guidelines, namely the one-hour bundle comprising an examination of lactate levels, blood cultures, administration of broadspectrum antibiotics, crystalloids, and vasopressors. The SSC guidelines also recommend that ScvO2 monitoring can improve the prognosis of patients with septic shock. One of the non-invasive tissue oxygenation monitoring techniques is near-infrared spectroscopy (NIRS) which can estimate cerebral oxygenation. The study stated that the measurement of cerebral oxygen saturation (rSO2) using NIRS correlated with ScvO2, where rSO2 correlates with ScvO2 in septic patients significantly. Aim: To figure the description of cerebral oxygenation after one-hour bundle administration in the management of sepsis patients at Haji Adam Malik General Hospital Medan. Methods: This study is an analytic interventional study to determine the description of cerebral oxygenation after the one-hour bundle administration in septic patients. After obtaining approval from the Ethics Committee of the Faculty of Medicine, University of North Sumatra, based on the inclusion and exclusion criteria, we collect 30 research samples. The study sample was all patients diagnosed with sepsis and treated with one-hour bundle sepsis that met the inclusion and exclusion criteria. Results: This study found that the mean value of SBP T0 is 88,03. The mean value of SBP T1 is 103. In DBP we found that the mean value of DBP T0 is 55,27, while the mean value of DBP T1 is 59,27. The mean value of HR T0 is 117,57. Mean value of HR T1 is 110,87. In the examination of rSO2, the mean value of right cerebral oxygentation before and 1 hour after the administration of the sepsis bundle are 46,5 and 49,76 and the mean value of left cerebral oxygentation before and 1 hour after the administration of the sepsis bundle are 46,76 dan 50,32 in an order. There was a significant difference in the right rSO2 similar with the left rSO2 before and 1 hour after the administration of the sepsis bundle.

Keywords : Sepsis, rSO2, SBP, DBP, HR.


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