Perbedaan Central Venous Pressure dan Stroke Volume Variation dalam Menilai Respon Cairan pada Pasien Sepsis di ICU RSUP Haji Adam Malik Medan

Abstract

Background: Hypotension and inadequate organ perfusion are common hemodynamic disturbances in critical patients in the ICU. Hemodynamic evaluation is important to restore tissue perfusion and prevent organ dysfunction. Research shows stroke volume variation (SVV) is superior to central venous pressure (CVP) in assessing fluid response. Invasive and non-invasive methods are used to measure intravascular volume, but there is no ideal parameter, so it needs contextual clinical interpretation. Research Methods: This study is an experimental study with a pretest-posttest approach to analyze the difference in fluid therapy response by measuring CVP and SVV values before and after fluid therapy in sepsis patients admitted to the ICU of H. Adam Malik Hospital Medan. The study was conducted after Ethical clearance was issued by the Ethics Committee of the Faculty of Medicine, University of North Sumatra and H. Adam Malik Hospital Medan, with a total sample of 38 people. Results: This study analyzed the response of fluid therapy using Stroke Volume Variation (SVV) and Central Venous Pressure (CVP) in sepsis patients in the ICU of H. Adam Malik Hospital Medan. Of the 40 samples, the mean age was 53.75±7.38 years and the majority were female (72.5%). Results showed significant differences in systolic and diastolic blood pressure, MAP, and HR before and after fluid therapy (p<0.05). SVV increased from 25.72±3.53% to 28.02±4.01% and CVP from 6.30±1.18 mmHg to 8.00±1.55 mmHg (p<0.05). The majority of the increase in CVP was in line with the increase in SVV (p<0.05). Conclusion: After the administration of fluid therapy in sepsis patients, there was an increase in blood pressure, Mean Arterial Pressure (MAP), and heart rate. In addition, there was an increase in Stroke Volume Variation (SVV) and Central Venous Pressure (CVP) values. A significant relationship between CVP and SVV values was also found in sepsis patients after fluid therapy.