ERICA GILDA
Program Pendidikan Konsultan Intensive Care
FK UI / RSUPN Cipto Mangunkusumo
Jakarta 2016
ILUSTRASI KASUS
Pasien Tn. S, 67 tahun
BB 50 kg, TB 160 cm
No RM 412 - 99 77
Pasien masuk resusitasi RSCM 26 Agustus 2016
Pasien masuk ICU IGD tanggal 2 Agustus 2016
Masuk
IGD
resusitas
i RSCM
Jam 3.30
26 juli s/d 1
agustus 2016
2 Agustus s 2016
S
B
T
16 Agustus
2016
22
Agustus,
pindah
ruang IPD
ILUSTRASI
KASUS
FEBRUARI
2016
DESEMBER
2015
8 bulan SMRS pasien
mengeluh sesak napas
Berobat ke Klinik namun
tak ada perubahan
26 JULI 2016
25 JULI 2016
RSCM
RS Jati
Sampur
na
JUNI 2016
1 bulan SMRS
sesak semakin
memberat +
tidak nafsu
makan dan
minum
Tatalaksana
IGD
Px. ANESTESI
26JULI 2016
Fungsi Hepar
SGOT/SGPT : 4161/1632
Albumin : 3,63
Bilirubin T/D/i :
4,42/3,36/1,0
Fungsi Ginjal
Ureum/Creatinin :
87,9/3,219
Hematologi
DPL :
13,8/47/8770/603
00
APTT : 52,0; 34
(K)
PT : 22,8; 10,5
D-dimmer : 1,1
Fibrinogen : 260,9
AGD :
7,108/79,3/79,7/2
5,3/89,5
Hemodinamik
Lactat : 5,6
Elektrolit :
132/5,7/97
Mg : 2,25
Terapi :
Ca (darah)Rencana
: 8,6
O2 kanul 5 lpm
IVFD: NaCl 0,9% 10 tpm
NGT Diet Jantung 1500 kkal
Inj. Meropenem 3 x 1gram
Inj. OMZ 1 x 40mg
Inpepsa 4 x 15mg (po)
Flumucyl 3 x 15mg (po)
Agustus
TD
70/50
169/78
160/78
169/78
106x
RR
SaO2
64-72x
91x
64-72x
91x
64-72x
91x
28x
24x
24x
24x
24x
24x
24x
65%
100%
100%
100%
100%
100%
100%
Suhu
Lactat
37
5,6
1,8
7,108
7,219
Norephin
eprine
0,5
pH
169/78
pCO2
66,9
pO2
96
HCO3
27,3
Px. ANESTESI
27 JULI 2016
S = Tenang, Kontak tak adekuat
O = A : on ETT
B : RR 24 kali/menit on ventilator;
MOV 75/14/5/40; SaO2 100%
C : TD / mmHg; N 64 - 72 kali/menit
on
Vascon 0,2mg/kgBB/menit, akral
hangat
D : DPO
E : T 36C
A = - Sepsis dengan MODS
- Penurunan kesadaran e.c sepsis
- Susp PPOK
- Riwayat TB paru
P = - Evaluasi kesadaran dan
hemodinamik
- Jika stroke rencana ekstubasi
- Cek AGD ulang
- Kultur sputum, darah dan urinalisa
Px. ANESTESI
28 JULI 2016
Px. ANESTESI
29 JULI 2016
S = Tenang, Kontak tak adekuat
O = A : on ETT
B : RR 24 kali/menit on ventilator;
MOV PS 14/5/40; SaO2 100%
C : TD 160/78 mmHg; N 64-72
kali/menit on
D : GCS E2VettM5
E : T 36C
A = - Penurunan kesadaran ec sepsis
- Sepsis dengan MODS
- Susp PPOK
- Riwayat TB Paru
P = - Stop sedasi, evaluasi kesadaran
dan
hemodinamik
- Jika stroke rencana ekstubasi
- Cek AGD ulang
- Kultur sputum, darah dan urinalisa
Px. ANESTESI
30 JULI 2016 ?
Px. ANESTESI
31 JULI 2016 ?
S = Tenang, Kontak tak adekuat
O = A : on ETT
B : RR 24 kali/menit on ventilator;
MOV 75/14/5/40; SaO2 100%
C : TD / mmHg; N 64 - 72 kali/menit
on
Vascon 0,2mg/kgBB/menit, akral
hangat
D : DPO
E : T 36C
A = - Sepsis dengan MODS
- Penurunan kesadaran e.c sepsis
- Susp PPOK
- Riwayat TB paru
P = - Evaluasi kesadaran dan
hemodinamik
- Jika stroke rencana ekstubasi
- Cek AGD ulang
- Kultur sputum, darah dan urinalisa
Px. ANESTESI
1 AGUSTUS
2016 ?
26 JULI 2016
IGD
Masuk
IGD
RESUSITASI
DIAGNOSA MEDIK
IGD RESUSITASI
Saat
diruang
resusitasi,
pasien
mengalami
penurunan kesadaran. Kemudian di intubasi dan
diberikan bantuan ventilasi mekanik.
160 160
120 120
80
80
40
40
9
36,7
10
11
37,5
12
13
14
37,9
15
16
17
37,5
18
19
20
21
22
23
24
7 RR
37
50
40
30
20
DPL: 13,6/45,5/12.900/118.000
20 20
AGDv :
SpO2 (%)
99
100
100
100
100
100
100
100
100
100
100
100
Inpepsa 4 x 15 ml
100
100
100
100
100
100
7,35/80,5/40,3/69,2/15,7/44,9
CVP (cmH2O)
+13
+18
Simvastatin
MAP(mmHg)
86
87
70
70
83
81
86 1 x 20
82 mg 86
86
83
89
AGDa
:
:
82
80
84
92
112
105
PEEP
+5
+5
+5
+5
+5Paraenteral
+5
+5
+5
+5
+5
+5
S: sesak,
pola nafas
kesadaran
+5
+5
+5 bagging,
+5 penurunan
+5
+5
+5 Meropenem 2 x 1 gr STOP
7,38/60,4/114,6/98,2/9,9/36,3
CVC (+)
Omeprazole 2 x 40 mg
O: kes: E2M5Vtube TD: 124/85mmHg HR: 86x/mnt
Metil prednisolon
1 x 62,5Ca
mg
STOP
Ca (darah):
8,9mg/dL
(ion):
SpO2: 100% T: 36,2 C
JantungBJ I/II normal
E1 Tygecyclin 100 mg drip 1 jam; 12 jam
1,22mmol/L
Paru: vesikuler +/+, ronkhi +/- kasar, wheezing
Asam folat 2 x 5 mg
Kultur Sputum
10
0
100
+14
73
+5
100
100
100
100
+11
79
+5
80
+5
88
+5
66
+5
F: MC 30 ml/jam
A: Morphin 1 mg/jam
S: T: H: Head elevation 30
U: Omeprazole 2 x 40mg
G: GDS per 24 jam
Input: 1118
Output: 1350
UO: 0,937 ml/kgBB/jam
Balans: - 232
BK : - 232
160 160
9
36,7
10
11
12
13
37,5
14
37,9
15
16
37,5
17
18
19
20
21
22
23
24
7 RR
37
50
40
120 120
80
80
40
40
30
20
Aib-serum :2,66
AGDv : 7,39/64,2/48,7/76,8/13,2/39,8
20 20
AGDa
: 7,41/59,0/103,7/97,8/12,3/38,2
SpO2 (%)
100
100
100
100
100
100
100
100
100
100
1 00
100
100
100
100
100
100
100
100 Elektrolit:
100
100
P:
151/4,7/107
CVP (cmH2O) + 14,5
+ 11
+9
Enteral :
+6
MAP(mmHg)
95
95
98
79
69
80
88
92
83
77
78
81
71
76
76
GDS: 115 Curcuma
PCT : 0,24
3 x 200 mg
74
77
92
87
98
118
PEEP
+5
+5
+5
+5
+5
+5
+5
+5
+5
+5
+5
+5
+5
+5
S: tenang
3 x 7,5 mg
57 CK-MB:
+5 TD: 130-150/
+5
+5
+5 CK:
+570130
+5 HP Pro
+5 12,8
O: DPO
50-90mmHg
HR:
Asam folat 2 x 5 mg
F: MC 70 ml/jam
x/menit
Ca (darah):Inpepsa
8,6mg/dL
4 x 15 ml Ca (ion): 1,19mmol/L Mg :
RR: 12-15x/menit SpO2: 100% T: 36-36,6 C
A: Morphin 1 mg/jam
2,24 mg/dLSimvastatin 1 x 20 mg
Jantung: BJ I/II normal
S: Neurodex 2 x 1 tab
Paru: vesikuler +/+, ronkhi +/- kasar,
T: Laktat: 1,2Paraenteral :
wheezing
10
0
100
100
+5
70
+5
76
+5
A:
- Sepsis e.c CAP dd/ TB Paru gagal nafas tipe
II
- Penurunan kesadaran e.c. C02 narkose
- AKI dd/ Acute on CKD
- CHF FC II
- Acute liver injury
- Ulkus dekubitus
Omeprazole 2 x 40 mg
E2 Tygecyclin 2 x 50 mg ( drip 1 jam)
E2 Levofloxcacin 1 x 500 mg
E2 Mycafugin 1 x 100 mg
Dactarin salep 2x/hari
Ca- Gukonas 2 x 1 gr
Inhalasi:
Bisolvon - Ventolin dalam NS / 6jam
Output: 3970 cc
Balans: - 1738 cc
160 160
12
36,7
13
14
37,5
15
16
37,9
17
18
37,5
19
20
37
21
22
23
24
50
40
120 120
80
80
40
40
30
20
10
AGDa : 7.467/53.8/97.7/15.2/39.3/97,1
AGDv : 7.414/71.0/43,3/18.0/45.9/76.7
SpO2 (%)
99
100
100
100
100
100
100
100
100
100
100
100
100
145/3,5/105
100
100
100
100
100 Elektrolit:
100
CVP (cmH2O)
+6,5
+6,5
+5
+7
+6
+5
Ca (darah):
8,4mg/dL
Ca
1,05mmol/L
Mg :93
MAP(mmHg)
80
62
87
80
62
76
76
82
83 (ion):
64
66
92
98
100
92
99
100
1,40 mg/dL
P:
F: MC 70
- Curcuma 3x200mg
S: tenang, nafas spontan
A: GDS 113
- HP Pro 3x 75mg
O: kes: CM TD: 120/55 HR: 100-110x/mnt
S: Morfin
- Asam folat 2x5mg
Laktat: 0,8
RR: 14x/ mnt SpO2: 99-100%
T: 20
20
7 RR
- Inpepsa 4x15mg
- Simvastatin 1x20mg
- Neurodex 2x1tab
- E3 Tygacyl 2x50mg
- E3 Levofloxacin 1x500mg
- E3 Mycafungin 1x100mg
- OMZ 2x40mg (IV)
- Daktarin 2x1 salep
- Ca Glukonas 2x1gr
- Inhalasi VB.NS/6jam
0
100
87
100
102
99
100
98
160 160
9
36,7
10
11
37,5
12
13
14
37,9
15
16
37,5
17
18
19
20
21
22
23
24
7 RR
37
50
40
120 120
80
80
40
40
30
20
10
DPL: 15/47,9/20,400/112.000
SGOT 44 SGPT 195
Ur 76,2 Cr 0,71P:Enteral :
SpO2 (%)
100
100
100
100
100
100
100
100
100
94
100
100
100
98
98
AGDv
: 7,40/75,5/42,3/79,4/20,6/44,5
Lasix 1 x 4o mg
100
100
100
100
100
100
CVP (cmH2O) +5
+11
+7
+5,5
Bisoprolol 1 x 5 mg
AGDa : 7,44/63,2/107,7/98,0/17,9/43,7
MAP(mmHg)
69
70
82
82
94
80
76
71
91
81
88
78
80
73
70
Curcuma 3 x 200 mg
145/4/101
S: 77
gelisah sesekali
77
78
90
80Elektrolit:
94
HP Pro 3 x 7,5 mg
F: MC 70 ml/jam
O: DPO TD: 135/74mmHg HR: 119 x/menit
GDS:RR:
111
Asam folat
x 5 mg
A: Morphin 1 mg/jam
12x/menit
Ca (darah): 8,4mg/dL
Ca 2
(ion):
1,66mmol/L Mg : 1,60 mg/dL
T: 36,10C SpO2: 100% on PC 14/16/5/40
Inpepsa 4 x 15 ml
S: Miloz 1 mg/jam
Laktat: 1,5
Jantung: BJ I/II normal
20
20
Simvastatin 1 x 20 mg
Neurodex 2 x 1 tab
Paraenteral :
Omeprazole 2 x 40 mg
E4 Tygecyclin 2 x 50 mg ( drip 1 jam)
E4 Levofloxcacin 1 x 500 mg
E4 Mycafugin 1 x 100 mg
Dactarin salep 2x/hari
Ca Glukonas 2 x 1 gr
0
99
78
100
79
160 160
9
36,7
10
11
12
37,5
13
14
37,9
15
16
37,5
17
18
19
20
21
22
23
24
37
50
40
120 120
80
80
40
40
7 RR
30
20
10
AGDv : 7,40/65,5/49,3/82,5/13,3/40,9
20 20
P:
AGDa : 7,46/56,8/171,7/99,5/15,3/40,19
Enteral :
SpO2 (%)
100
100
100 Elektrolit:
100
100 147/3,2/95
100
100
100
100
100
100
100
100
100
Lasix100
1 x 4o
mg 100
STOP100
100
100
100
100
100
100
CVP
(cmH2O) aritmia,
+4
+4banyak dan
+6
+4
Bisoprolol 1 x 5 mg
S:
takikardia,
dahak
GDS:
103
MAP(mmHg)
80
86
94
95
96
88
87
99
73
67
81
68
61
70
75
74
74
Curcuma 3 x 200 mg
kental
65
73
75
67
80
84
Ca (darah):
8,1mg/dL
HP Pro
3 x 7,5 mg Ca (ion): 1,09mmol/L F: MC 70 ml/jam
O: BPO TD: 113/65 on NE
A: 0,1mcg/kgBB/menit dan xbncbnMg : 1,72
Asam
folat 2 x 5 mg
mg/dL
S: Miloz 1 mg/jam
0,1mcg/kgBB/menit HR: 116 x/menit RR:
Inpepsa 4 x 15 ml
1,0
T: Heparin 10.000ui/ 12jam
12x/menit T: 36,1 C SpO2: 100%Laktat:
on PC
Simvastatin 1 x 20 mg
0
50/5/12/14
Jantung: BJ I/II normal
Paru: vesikuler +/+, ronkhi +/- kasar,
wheezing
A:
- CO2 Narkose susp. PPOK ec SPOT
- Sepsis e.c CAP dd/ TB Paru
- AKI dd/ Acute on CKD
- Acute liver injury
Neurodex 2 x 1 tab
Paraenteral :
Omeprazole 2 x 40 mg
E5 Tygecyclin 2 x 50 mg ( drip 1 jam)
E5 Levofloxcacin 1 x 500 mg
E5 Mycafugin 1 x 100 mg
Dactarin salep 2x/hari
Ca Glukonas 2 x 1 gr
160 160
9
36,7
10
11
37,5
12
13
14
37,9
15
16
37,5
17
18
19
20
21
22
23
24
37
50
40
120 120
80
80
40
40
30
20
10
AGDv : 7,346/87,4/55,5/84,6/19,0/48,5
AGDa : 7,362/78,4/99,0/96,8/15,9/44,9
SpO2 (%)
98
95
96 Elektrolit:
100
100 P:
100
100
100 Ur:100
100 0,66
100
100
100
100
100
145/3,0/102
62,6100 Cr:
100
100
100
100
100
100
100Enteral :
CVP (cmH2O)
+4
+11SGOT: 54 Curcuma
+14
+11
200 mg+8
SGPT:3 x121
MAP(mmHg)
79
83
75
68
81
72
71
68
75
83
85
80
86
HP89
Pro 3 x827,5 mg70
S: 94
takikardia,
kental
GDS:
PCTfolat
: 8,7
94 aritmia,
121dahak
120banyak
80dan
76 92
Asam
2 x 5 mg
F: MC 70 ml/jam
O: DPO TD: 113/65mmHg on NE
Inpepsa
4 x 15 ml Ca (ion): 1,15mmol/L Mg :
Ca
(darah):
8,11mg/dL
A: 0,1mcg/kgBB/menit dan xbncbn
Simvastatin 1 x 20 mg
0,1mcg/kgBB/menit HR: 116 x/menit RR:
S: Midazolam 1 mg/jam
1,32 mg/dL
Neurodex 2 x 1 tab
12x/menit T: 36,1 C SpO2: 100% on PC
T: x 5 mg
PT: 12,9 K Bisoprolol
10,4 ; 1APTT:
125,8 K 33,3
50/5/12/14
H: Head elevation 45
Jantung: BJ I/II normal
U: Omeprazole 2 x 40mg
Laktat: 0,7Paraenteral
Aib serum:
2,28
:
Paru: vesikuler +/+, ronkhi +/- kasar, wheezing
20
20
A:
-
7 RR
Input: 2015,4 cc
Output: 2050 cc
UO: 1,92 cc/kgBB/jam
Balans: - 34,6cc
BK : - 5238,2 cc
0
100
92
160 160
9
36,7
10
11
37,5
12
13
14
37,9
15
16
37,5
17
18
19
20
21
22
23
24
37
50
40
120 120
80
80
40
40
30
20
AGDv : 7,35/77,6/46,8/77,8/16,7/45,0
AGDa : 7,519/46,2/137,1/99,2/13,9/32,0
20 20
Elektrolit: 146/3,2/99
P:
SpO2 (%)
98
95
96
100
100
100
100
100
100
100
100
100
100
100
100
Ur:
62,6
Enteral
Cr: 0,66
:
100
100
100
100
100
100
100
Curcuma
3 x 200 mg
CVP (cmH2O)
+4
+11
+8
+14
+11
SGOT:
54
SGPT:
12170
HP
MAP(mmHg)
79
83
75
68
81
89 Pro 3
82x 7,5 mg
72
71
68
75
83
85
80
94
94
121
120
80GDS:
76 89
Asam
folat
2
x
5
mg
PCT : 8,7
F: MC 70 ml/jam
S: takikardia, aritmia, dahak banyak dan kental
Inpepsa 4 x 15 ml
O: DPO TD: 113/65mmHg on NE
A: Mg
Ca (darah):Simvastatin
7,8mg/dL
Ca
:
1 x 20
mg (ion): 1,08mmol/L
0,1mcg/kgBB/menit dan xbncbn
S:
Midazolam
1 mg/jam
2 x 1 tab
0,1mcg/kgBB/menit HR: 116 x/menit1,13
RR: 12x/menit
mg/dLNeurodex
T:
Bisoprolol 1 x 5 mg
T: 36,1 C SpO2: 100% on PC 50/5/12/14
H: Head elevation 45
PT: 16,6 K 12,4 ; APTT: 81,8 K 35,3
Jantung: BJ I/II normal
U: Omeprazole 2 x 40mg
Paraenteral :
Paru: vesikuler +/+, ronkhi +/- kasar,Laktat:
wheezing -/-0,7
Aib
serum:
2,68
E7 Tygecyclin 2 x 50 mg ( drip 1 jam)
G: GDS per 24 jam
A:
0
7 RR
E7 Levofloxcacin 1 x 500 mg
E7 Mycafugin 1 x 100 mg
Ca Glukonas 2 x 1 gr
Omeprazole 2 x 40 mg
Dactarin salep 2x/hari
Inhalasi :
Input: 2015,4 cc
Output: 2050 cc
UO: 1,92 cc/kgBB/jam
Balans: - 34,6cc
BK : - 5238,2 cc
10
0
100
86
100
92
160 160
10
36,7
11
37,5
12
13
14
37,9
15
16
37,5
17
18
19
20
21
22
23
24
37
50
40
120 120
80
80
40
40
20
20
30
20
10
DPL : 13,9/44,9/17400/84000
P:
SpO2 (%)
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
AGDv
:
7,40/65,5/49,3/82,5/13,3/40,9
Enteral :
100
100
100
100
100
100
Curcuma 3 x 200 mg
CVP (cmH2O)
+4
+11
+8
+14
+11
AGDa
:
7,46/56,8/171,7/99,5/15,3/40,19
HP Pro 102
3 x 7,5 mg
MAP(mmHg)
98
98
78
84
83
83
85
87
61
82
80
89
84
83
83
91
88
91
90
89 Elektrolit:
95
Asam
folat 2 x 5 mg
139/2,5/108
F: MC 70 ml/jam
Inpepsa 4 x 15 ml
S: dahak banyak
A: (darah):
7,8mg/dL
Ca (ion): 1,08mmol/L
Simvastatin
1 x 20 mg
O: DPO TD: 142/71mmHg HR:82 x/menitCa
RR:12-23
S: x/menit T: 35,8 C SpO2: 100%
Neurodex 2 x 1 tab
Mg
:
1,49mg/dL
T: Jantung: BJ I/II normal
Bisoprolol 1 x 5 mg
H: Head elevation 45
Paru: vesikuler +/+, ronkhi +/- kasar, wheezing
-/PT: 12,5
K 10,4 ; APTT: 57 K 1,7
U: Omeprazole 2 x 40mg
A:
Paraenteral :
2,56
- CO2 Narkose susp. PPOK ec SPOT Aib serum:
E8 Tygecyclin 2 x 50 mg ( drip 1 jam)
G: GDS per 24 jam
0
7 RR
E8 Levofloxcacin 1 x 500 mg
E8 Mycafugin 1 x 100 mg
Ca Glukonas 2 x 1 gr
Omeprazole 2 x 40 mg
Dactarin salep 2x/hari
Inhalasi :
Input: 2449 cc
Output: 2650 cc
UO: 1,84 cc/kgBB/jam
Balans: - 201cc
BK : - 3396,3 cc
0
100
83
160 160
9
36,7
10
11
12
37,5
13
14
15
37,9
16
37,5
17
18
19
20
21
22
23
24
7 RR
37
50
40
120 120
80
80
40
40
30
20
DPL : 12,0/38,4/14700/98200
AGDv : 7,40/65,5/49,3/82,5/13,3/40,9
20 20
AGDa : P:
7,46/56,8/171,7/99,5/15,3/40,19
SpO2 (%)
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
147/3,7/100
Enteral
:
100
100
100
100
100Elektrolit:
100
CVP (cmH2O)
+12
+2
Curcuma 3 x 200 mg+3
Ca84(darah):
7,8mg/dL
Ca
(ion):
1,04mmol/L
Mg
:
MAP(mmHg)
88
90
84
81 HP Pro
90
96
100
83
92
90
130
93
92
72
74
3 x 7,5 mg
S: Tenang
rencana91trakeostomi
100
91
90
89
95
Asam folat 2 x 5 mg
1,18mg/dL
O: CM TD: 100-150/70-85mmHg HR:80F: MC 70 ml/jam
Inpepsa 4 x 15 ml
100 x/menit RR:15-30 x/menit T: 35,8A: GDS : 86Simvastatin 1 x 20 mg
36,40C SpO2: 100%
S: Neurodex
2 ;x 1
tab
PT:
13,0
K
10,6
APTT:
50,0
K
33,8
Jantung: BJ I/II normal
T: Bisoprolol 1 x 5 mg
Aib serum: 3,2
Paru: vesikuler +/+, ronkhi +/- kasar,
H: Head elevation 45
wheezing -/U: Omeprazole 2 x 40mg
:
Lactat : Paraenteral
0,9
A:
-
Input: 2449 cc
Output: 2650 cc
UO: 1,84 cc/kgBB/jam
Balans: - 201cc
BK : - 3396,3 cc
10
0
100
80
160 160
9
36,7
10
11
37,5
12
13
14
37,9
15
16
37,5
17
18
19
20
21
22
23
24
37
50
40
120 120
80
30
80
20
DPL : 12,0/38,4/14700/98200
AGDv : 7,453/52,1/37,3/71,2/10,8/35,2
AGDa : 7,495/43,3/190/99,7/10,0/33,7
20 20
Elektrolit:
147/3,7/100
SpO2 (%)
100
100
100
100
100HP Pro
100 3 x 7,5
100 mg 100
100
100
100
100
100
100
100
Asam
folat
2
x 5 mg
100
100
100
100
100
100
Ca
(darah):
7,8mg/dL
Ca
(ion):
1,04mmol/L
Mg
:
CVP (cmH2O) +3,5
+6,54 x 15 ml
+4
+7
Inpepsa
MAP(mmHg)
76
76
72
641,18mg/dL
78
87
70
103
103
103
87
87
94
97
108
Simvastatin 1 x 20 mg
60
70
91
81
84
88
S: post trakeostomi
2 x 1 tab
F: MC 70 ml/jam
GDS Neurodex
: 86
O: CM; TD: 120/70mmHg HR:93 x/menit
Bisoprolol 1 x 5 mg
A: PT: 13,0
K 10,6 ; APTT: 50,0 K 33,8
RR:20x/menit T: 36,5 C SpO2: 100%
S: Jantung: BJ I/II normal
Aib
serum:
3,2
T: Paru: vesikuler +/+, ronkhi +/- kasar, wheezing Paraenteral :
E10
Tygecyclin
2
x
50
mg
(
drip
1
jam)
H: Head elevation 45
-/Lactat : 0,9
40
40
A:
-
7 RR
PPOK ec SPOT
AKI dd/ Acute on CKD
Acute liver injury
Ulkus dekubitus
P:
Enteral :
Curcuma 3 x 200 mg
U: Omeprazole 2 x 40mg
G: GDS per 24 jam
Input: 2449 cc
Output: 2650 cc
UO: 1,84 cc/kgBB/jam
Balans: - 201cc
BK : - 3396,3 cc
10
0
100
102
100
91
160 160
10
36,7
11
37,5
12
13
14
37,9
15
16
37,5
17
18
19
20
21
22
23
24
37
50
40
120 120
80
80
40
40
7 RR
30
20
10
P:
DPL :Enteral
10.7/34.0/11600/99900
:
20 20
AGDv
: 7,433/52,1/37,3/71,2/10,0/35,2
Topamax
2 x 50 mg
SpO2 (%)
100
100
100
100
100
100
100 mg 100
100
100
100
100
100
100
100
100
Curcuma
3 x 200
: 7,472/44,9/198,8/99,6/9,2/33,0
100
100
100
100
100 AGDa
100
HP Pro 3 x 7,5 mg +6
CVP (cmH2O)
+6
+8,5
+8
Elektrolit:
140/3,5/111
MAP(mmHg)
86
61
70
67
66
70 2 x 68
77
76
70
70
56
72
Asam
folat
5 mg 73
72
73
78
92
98
113
S: hematokezia
Ca (darah):
Ca (ion): 1,19mmol/L Mg
: 70 ml/jam
Inpepsa 48,3mg/dL
x 15 ml
F: MC
O: DPO TD: 115/58mmHg HR:82 x/menit
Simvastatin 1 x 20 mg
A: 1,29mg/dL
RR:12-20 x/menit T: 36,3 C SpO2: 100%
Neurodex 2 x 1 tab
S: Jantung: BJ I/II normal
PT: 11,6
K 10,9
; 5APTT:
44,5
K mg
32,6
Bisoprolol
1
x
mg
1
x
2,5
Input: 2288.7 cc
Output: 1700 cc
UO: 1,1 cc/kgBB/jam
Balans: +588.7 cc
BK : -4032.5 cc
0
100
72
BP
HR
200
Suhu
200
160 160
36,7
10
11
37,5
12
13
14
37,9
15
16
37,5
17
18
19
20
21
22
23
24
50
37
40
120 120
80
80
40
40
20
20
30
20
10
P:
DPL : 10.0/31.4/8340/74600
SpO2 (%)
100
100
100
100
100Topamax
100 2 x 50
100mg 100
100
100
Curcuma 3 x 200 mg
100
100
100
100
100AGDv
100 : 7,332/79,0/50,2/79,9/14,1/42,3
CVP (cmH2O)
+9
+7,5
+8
HP Pro 3 x 7,5 mg
AGDa : 7,349/71,3/135,6/98,6/12,1/39,6
MAP(mmHg)
77
100
111
114
83 Asam51
93
93
folat 2 107
x 5 mg 107
144/2,7/107
133
135
135
130
89 Elektrolit:
71
Inpepsa
4 x 15 ml
PT: 11,8 KSimvastatin
10,4 ; APTT:
S: kejang
1 x 2040.3
mg K 33,7
O: DPO TD: 158/75mmHg HR:68 x/menit
RR:12Neurodex
2
x
1
tab
GDS : 183
14 x/menit T: 35,80C SpO2: 100%
Bisoprolol 1 x 2,5 mg
Aib serum: 3.28
Jantung: BJ I/II normal
Asam laktat
: 1,1 :
Paru: vesikuler +/+, ronkhi +/- kasar, wheezing
Paraenteral
-/A:
-
7 RR
100
63
100
+9
76
100
100
100
98
89
81
100
61
F: MC 70 ml/jam
A: S: Miloz 2mg/jam
T: H: Head elevation 40 - 45
U: Omeprazole 2 x 40mg
G: GDS per 4 jam
Input: 2517.8 cc
Output: 2940 cc
UO: 2.04 cc/kgBB/jam
Balans: - 422.2cc
BK : - 4454.7 cc
100
125
200 200
160 160
36,7
9
10
37,5
11
12
37,9
13
14
15
37,5
16
17
37
18
19
20
21
22
23
24
50
40
120 120
80
80
40
40
7 RR
30
20
DPL :10,1/31,3/8940/150000
HP Pro 3 x 7,5 mg
folat 2 x 5 mg
AGDv Asam
: 7,37/51,9/46,3/79,8/5,2/30,4
20 20
Inpepsa
15 ml 100
SpO2 (%)
100
100
100
100
100 : 7,401/43,2/172,3/99,4/2,7/27,1
100 4 x100
100
100
100
100
100
100
100
100
100
AGDa
100
100
100
100
100
100
Simvastatin 1 x 20 mg
CVP (cmH2O)
+9
+6,5 Elektrolit: +6
+5,5
+7
146/3,4/110
Neurodex
2 x 1 tab
MAP(mmHg)
105
104
107
98
88
99
109
111
105
97
112
85
75
68
65
69
69
Bisoprolol
1 ;x APTT:
2,5 mg 42,0 K 33,7
PT:
11,4
K
10,4
60
74
80
81
97
75
S: tidak ada kejang, tidak BAB darah
F: MC 70 ml/jam
Omeprazole 2 x 40 mg (po)
O:E4M6Vx TD: 110/72mmHg HR:87 x/menit
RR:23
GDS
93
A: x/menit
Ca (darah):
8,7mg/dL
Ca (ion): 1,96mmol/L Mg : S: Paraenteral
:
T: 36,1 C SpO2: 100%
T: Jantung: BJ I/II normal
E13 Tygecyclin 2 x 50 mg ( drip 1 jam)
1,36mg/dL
H: Head elevation 45
Paru: vesikuler +/+, ronkhi +/- kasar, wheezing -/- Asam traneksamat 3 x 500 mg (drip)
Aib
serum:
3,2
U: Omeprazole 2 x 40mg
A:
Neo-K 3 x 10 mg
- PPOK ec SPOT
G: GDS per 24 jam
Lactat Dicynone
: 0,9 3 x 500 mg
0
Status epileptikus
- Sepsis e.c CAP dd/ TB Paru
- Shock iskemik
P:
Enteral :
Topamax 2 x 50 mg
Curcuma 3 x 200 mg
Input: 2449 cc
Output: 2650 cc
UO: 1,84 cc/kgBB/jam
Balans: - 201cc
BK : - 3396,3 cc
10
160 160
9
36,7
10
11
12
37,5
13
14
37,9
15
16
37,5
17
18
19
20
21
22
23
24
37
50
40
120 120
80
80
40
40
7 RR
30
20
10
DPL : P:
9,31/29,7/6400/116000
20 20
:
AGDvEnteral
: 7,40/65,5/49,3/82,5/13,3/40,9
Topamax 2 x 150 mg
AGDa
: 7,46/56,8/171,7/99,5/15,3/40,19
SpO2 (%)
100
100
100
100
100
100 3 x 100
100
100
Curcuma
200 mg100
CVP (cmH2O)
+6
+8
HP Pro146/3,6/114
3 x 7,5 mg+6
Elektrolit:
MAP(mmHg)
73
64
58
60
59
72
79
79
Asam folat 2 x745 mg 74
S: dahak banyak
Ur/Cr Inpepsa
: 40,84/x0,59
F: MC 70 ml/jam
15 ml
O: DPO TD: 142/71mmHg HR:82
A: 1 x 20 mg
GDS
:Simvastatin
76
x/menit RR:12-23 x/menit T: 35,8
C
S: Neurodex 2 x 1 tab
SpO2: 100%
Ca
(darah):
8,3mg/dL
Ca
(ion):
1,25mmol/L
Mg
T: - :
Bisoprolol 1 x 2,5 mg
Jantung: BJ I/II normal
H: Head elevation 45
Omeprazole 2 x 40 mg (po)
1,21mg/dL
Paru: vesikuler +/+, ronkhi +/- kasar,
U: Omeprazole 2 x 40mg
Lactolac 3 x i Cth
wheezing -/PT: 11,5 K 10,8 ; APTT: 45,3 K 34,7
G: GDS per 24 jam
A:
- CO2 Narkose susp. PPOK ec SPOT
Aib serum:
2,56
Paraenteral
:
Input: 2449 cc
- Sepsis e.c CAP dd/ TB Paru
3 x: 10
mg STOP
Output: 2650 cc
Asam Neo-K
lactat
2,0
- AKI dd/ Acute on CKD
0
36,7
9
10
37,5
11
12
37,9
13
14
15
37,5
16
17
37
18
19
20
21
22
23
24
50
200 200
160 160
40
120 120
80
80
40
40
7 RR
30
20
10
P:
DPL : 9,31/29,7/6400/116000
Enteral:
20 20
Lactulac
3x1
: 7,336/44,7/43,0/-1,1/24,1/75,1
SpO2 (%)
100
100
100 AGDv
100
100
100
100
100
100
100
100
100
100
100
100
100
Omeprazole
2x40mg
100
100
100
100
100
100
2x250mg
AGDa Topamax
:
7,392/39,2/178,3/-0,1/24,0/99,4
CVP (cmH2O)
+5
+9
+2
+3
+5
Curcuma
3x200mg
MAP(mmHg)
81
70
66
63
64
75
65
66
72
59
61
56
52
68
64
65
HP-Pro 146/3,6/114
3x7,5mg
Elektrolit:
57
60
68
82
74
75
F: MC 70 ml/jam
Asam folat 2x5mg
S: tenang
A: PT: 11,4
K 4x15ml
10,6 ; APTT: 41,6 K 34,1
O: DPO TD: 122/52mmHg N: 90x/menit
S: Inpepsa
S: Simvastatin 1x20mg
36,7 C P: 22-23x Sp)2: 100%
GDS
76
T: Neurodex 2x1
Jantung: BJ I/II normal
H: Head elevation 15-45
Bisoprolol 1x2,5mg
Paru: vesikuler +/+, ronkhi +/- kasar,
Laktat: 2,0
U: Omeprazole 2 x 40mg
0
wheezing -/A:
- Status epileptikus
- Riw. Penurunan kesadaran
- PPOK e.c. SOPT
- Shock iskemik
Parenteral:
Ringerfundine cvd
Ringerfundine
Hidonac 1200mg in water injection 12ml
KCl 25 mg in water injection 50 cc
MgSO4 5 gram
Asam Tranexamat 1 gram
Neo K 3x10mg
100
61
BP HR
Suhu
200 200
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
50
160 160
40
120 120
30
DPL : 9,06/30,4/7310/136
AGDv : 7,295/53,5/51,9/0,2/26,3/81,6
40 40
AGDa :7,340/41,5/193,7/-2,3/32,6/99.4
P: 139/3,9/123
Elektrolit:
20 20
Enteral:
SpO2 (%)
100
100
100 Ca 100
100
100
100
100 Ca
100
100 1,02mmol/L
100
100
100 Mg
100
(darah):
8,3mg/dL
(ion):
: 100 100
Lactulac
3x1
100
100
100
100
100
100
CVP (cmH2O)
+4
+2
+3
Omeprazole+4
2x40mg
1,33mg/dL
MAP(mmHg)
68
69
60
66
67Topamax
68 2x250mg
81
71
71
75
66
65
71
70
80
89
80
72
70
68
80 PT:90
3x200mg
F: MC 70 ml/jam
11,8Curcuma
K 10,5
; APTT: 39.3 K 33.4
S: tenang
HP-Pro 3x7,5mg
A: O:E4M5Vx TD: 113/50mmHg HR:67x/menit
GDS 78 Asam folat 2x5mg
S: RR:14x/menit
Inpepsa 4x15ml
T: PCT: 0,85
T: 36,1 C SpO2: 100%
Simvastatin 1x20mg
H: Head elevation 30-45
Jantung: BJ I/II normal
U: Omeprazole 2 x 40mg
Lactat : Neurodex
1,1 2x1
Paru: vesikuler +/+, ronkhi +/- kasar,
80
7 RR
80
wheezing -/A:
- Riwayat penurunan kesadaran
- PPOK ec SPOT
- Status epileptikus
- Shock iskemik
Bisoprolol 1x2,5mg
Parenteral:
Ca Glluconas 3x1gram
Dactarin salep
Dobutamin 250mg in water for injection 50cc
Input: 1565,4 cc
Output: 1700 cc
UO: 1.18cc/kgBB/jam
Balans: +165.4
BK : -4213.8
20
10
100
86
Suhu
8
10
36,7
11
37,5
12
13
14
37,9
15
16
37,5
17
18
37
19
20
21
22
23
24
7 RR
BP
HR
200
200
50
160
160
40
120
120
80
80
30
AGDv : 7,353/49,2/55,4/2,4/27,6/85,1
AGDa :7,442/41,4/89,4/4,6/28,5/97,2
Elektrolit: 142/3.3/108
P:
Enteral:
Ca (darah): 7.9mg/dL
Ca (ion): 1,22mmol/L Mg :
Lactulac 3x1
2x40mg
1,75mg/dL Omeprazole
Topamax 2x250mg
Curcuma
3x200mg 30,3 K 36,4
PT: 11,8 K 10,5
;3x7,5mg
APTT:
F: MC 70 ml/jam
HP-Pro
S: terpasang trachea tube
A: Asam
folat 2x5mg
O:E4M6Vx TD: 110/72mmHgAib
HR:87Serum:
x/menit RR:232,63
x/menit
S: Inpepsa 4x15ml
T: 36,1 C SpO2: 100%
T: Simvastatin 1x20mg
Ur/Cr: 29,4/0.361
Jantung: BJ I/II normal
H: Head elevation 30
Neurodex 2x1
Paru: vesikuler +/+, ronkhi +/- kasar, wheezing -/U: Omeprazole 2 x 40mg
GDS 93
Bisoprolol 1x2,5mg
G: GDS per 24 jam
A:
- PPOK ec SPOT
Asam lactat:Parenteral:
1.1
Input: 1614,9 cc
- Status epileptikus
40
20
40
20
20
SpO2 (%)
100
CVP (cmH2O)
MAP(mmHg)
88
100
100
+5
100
100
83
83
+5
100
100
85
82
100
100
95
92
100
100
93
94
92
100
100
100
100
88
77
87
+7
100
100
100
56
71
78
+6
83
100
100
100
100
+14
73
70
91
100
10
Ca Glluconas 3x1gram
Dactarin salep 2x1
Ringerfundine cvd
Ringerfundine
Dobutamin 250mg in water for injection 50cc
Hidonac 1200mg in water injection 12ml
Output: 1970 cc
UO: 1,3 cc/kgBB/jam
Balans: -355,1cc
BK : -4568,8cc
65
85
85
Suhu
8
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
7 RR
BP
HR
200
200
50
160
160
40
120
120
30
AGDv : 7,349/47,4/37,3/1,3/26,4/67,5
Elektrolit: 140/3.7/108
Ca (darah): 8,4 mg/dL Ca (ion): 1,23mmol/L Mg :
40
40
1,49 mg/dL
P: APTT: 33.3
PT: 10.9;
20
20
Enteral:
SpO2 (%)
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
Cr/Ur
:
0.32/26.3
100
100
100
100
100
100 Lactulac 3x1
CVP (cmH2O)
+5
+7
Omeprazole 2x40mg
Aib-Serum:
3.0 74
MAP(mmHg)
87
80
85
87
78Topamax
67 2x250mg
70
63
Curcuma 3x200mg 4.86/1.24
Bil-direk/Bil-indirek:
HP-Pro 3x7,5mg
S: tenang
F: MC 70 ml/jam
SGOT/SGPT:
105/107
2x5mg
O:E4M6Vx TD: 135/65 mmHg HR:79 x/menit RR: 13Asam folat
A: Inpepsa
4x15ml
S: x/menit
GDS 84Simvastatin 1x20mg
T: T: 36 C SpO2: 100%
H: Head elevation 30
Lactat :Neurodex
1.9 2x1
Jantung: BJ I/II normal
80
80
Paru: vesikuler +/+, ronkhi +/- kasar, wheezing -/- Bisoprolol 1x2,5mg
A:
- PPOK ec SPOT
Parenteral:
- Status epileptikus
Ca Glluconas 3x1gram
- Sepsis e.c CAP dd/ TB Paru
Dactarin salep
- Shock iskemik
Ringerfundine cvd
Dobutamin 250mg in water for injection 50cc
Hidonac 1200mg in water injection 12ml
U: Omeprazole 2 x 40mg
G: GDS per 4 jam
Input: 2015,4 cc
Output: 2050 cc
UO: cc/kgBB/jam
Balans: 34,6cc
BK : 5388,2 cc
20
10
100
100
25 Juli
2016
2 Agustus
2016
PEMERIKSAAN RONTGEN
4 Agustus
2016
5 Agustus
2016
10 Agustus
2016
PEMERIKSAAN RONTGEN
PEMERIKSAAN RONTGEN
5 Agustus
2016
PEMERIKSAAN BRONCHOSCOPY
HASIL
Bronkskopi dalam GA, Insersi di skope via ETT
Trakea bentuk dan kaliber normal
Karina sentral dan tumpul disertai bekas trauma
intubasi/suction berulang
BUKA BUKI : Semua orifisium terbuka sampai
cabang subsegmental disertai hipersekresi mukus
putih kental. Tampak segmen asesoris segmen
posterior (B3) lobus atas paru kanan. Tidak tampak
noul, massa dan perdarahan aktif.
Dilakukan BAL dengan NaCl 0,9% sebanyak 100cc
pada segmen anterior dan posterior (B2-B3) lobus
atas paru kanan pro MOR, Gram, BTA 1x, Sitologi, PCR
CMV
Pasien stabil pasca tindakan.
Kesimpulan :
Proses infeksi saluran napas bawah disertai
kelainan kongenital lobus atas paru kanan
Saean :
Chest Fisioterapi
Tunggu hasil pemeriksaan
EVALUASI CT SCAN
1.
2.
3.
Hasil
ECHOCARDIOGRAPH
Y
3 / 8 / 2016 :
Dilatasi RA
Global normokinetik
TR moderate, PR
mild
Fungsi sistolik LV dan
RV menurun
Disfungsi diastolik LV
grade I
PH mild
IVC dilatasi, tekanan
atrium kanan
meningkat lebih dari
20mmHg
PEMERIKSAAN EKG
1Agustus
2016
1Agustus
2016
PEMERIKSAAN EKG
2/8
3/8
4/8
5/8
6/8
7/8
8/8
9/8
Suhu
36,4
HR
95125
70130
100110
RR
1224
1215
14
MAP
3636,6
37
36,1
3636,7
119
16
36,0
8
10/
8
10
11
12
13
14
12/
8
13/
8
14/
8
15/
8
16/8
17/8
36,5
35,736,3
36,7
36,6
68
RR
87
70110
1214
23
MAP
1530
9
11/8
36,1
35,836,4
116
95100
74
80100
93
8295
12
1220
1220
1530
20
1220
4mg
4mg
4mg
4mg
Dobut
amin
Leukos
it
12.9
20.4
17,9
Laktat
0.7
1.2
0.8
1.5
0,7
HR
36,8
4mg
4mg
250
mg
250
mg
8mg
250
mg
14.7
12.9
10.3
0.9
1.4
1.3
8mg
250
mg
9.3
1.1 -
Dobutami
8mg
n
-5,2
-14,6
12,3
-8,7
-6,8
-8,8
-7,8
-7,8
18/8
19/8
36.1
35.2
36.0
36
90
67
60-80
79
22-23
14
16-25
20-26
59-86
63-95
57-87
250m
g
250m
g
250mg
250m
g
Leukosit
250
250
mg
mg
Laktat
Scvo2
8.9
1.9
6.4
Pco2, gap
PCT
19,8
17
52-81
phrin
Scvo2
Pco2,
gap
36,1
Norepine
72-120 64-108 61-113 63-135 65-112
58-79
Norepi
nephri
n
Suhu 36-
16
15
CPIS
-8,1
-10,1
-5.6
-5.1
-7.8
HP
Ke2
Tgl/Bln
2016
2/8
150
3.04
3/8
115
2.66
4/8
113
5/8
6/8
7/8
8/8
9/8
10/8
86
11/8
118
10
12/8
51
2.53
11
13/8
171
3.28
12
14/8
93
3.2
76.2
0.755
0.71
111
SGOT
(U/L)
SGPT
(U/L)
Bilirubin
T/D/I
80
397
2.54/2/0.54
44
195
54
121
62
68
103
62.6
0.663
92
2.68
3.2
11.08/9.87/1.21
HP
Ke2
Tgl/Bln
2016
PCT
(mg/dl)
2/8
0.24
Ca
(ion)
Mg
0.7
146
111
8.9
1.22
1.38
3/8
1.2
151
4.7
107
8.6
1.19
2.24
4/8
0.8
145
3.5
105
8.0
1.40
1.05
5/8
1.5
145
4.0
101
8.4
1.66
1.6
6/8
1.0
147
3.2
95
8.1
1.09
1.72
7/8
0.7
145
3.0
102
8.1
1.15
1.32
8/8
0.7
146
3.2
99
7.8
1.08
11.3
9/8
139
2.5
108
7.8
1.08
1.49
10/8
0.9
147
3.7
100
7.8
1.04
1.18
11/8
1.4
139
2.6
103
7.8
1.67
1.04
10
12/8
1.3
144
2.7
107
8.3
1.19
1.29
11
13/8
1.1
144
3.5
110
12
14/8
1.5
141
3.4
114
8.7
1.26
1.36
13
15/8
2.0
146
3.6
114
8.3
1.25
1.2
2.27
2.19
CRP
Tgl/Bln 2016
pH
PaCO2
PaO2
SaO2
HCO3
BE
2/8
7,351
80,5
40,3
69,2
44,9
15,7
3/8
7,394
64,2
43,7
76,8
39,6
13,2
4/8
7,414
71,0
43,3
76,7
45,9
18,0
5/8
7,409
75,5
42,5
79,4
44,5
20,6
6/8
7,400
65,5
49,3
82,5
40,9
13,3
7/8
7,346
87,4
55,5
84,0
48,3
19,0
8/8
7,368
77,6
46,8
77,8
45,0
16,7
9/8
7,380
66,2
40,3
71,7
39,5
12,2
10/8
7.398
64.3
42.4
75.5
40.1
13.4
11/8
7,433
52,1
37,3
71,2
35,2
10,0
10
12/8
7,424
52.7
43.4
78.7
34.8
9.9
11
13/8
7,332
79,0
50,2
79,9
42,3
14,1
12
14/8
7,371
51,9
46,3
79,8
30,4
5,2
13
15/8
7,375
46,3
31,4
58,1
27,3
2,5
14
16/8
7,336
44,7
43,0
75,1
24,1
-1,1
15
17/8
7,295
53,5
51,9
81,6
26,3
0,2
16
18/8
7,353
49,2
53,4
85,1
27,6
2,4
Tgl/Bln 2016
pH
PaCO2
PaO2
SaO2
HCO3
BE
2/8
7,382
60,4
114,6
98,2
36,3
9,9
3/8
7,416
59,0
103,7
97,8
38,2
12,3
4/8
7,467
53,8
97,7
97,1
39,3
15,2
5/8
7,444
63,2
107,7
98,0
43,7
17,9
6/8
7,461
56,8
17,7
99,5
40,9
15,3
7/8
7,362
78,4
99,0
96,8
44,9
15,9
8/8
7,415
46,2
132,1
99,2
38,0
13,9
9/8
7,439
52,7
121,6
98,7
36
10,6
10/8
7,422
57,5
139,5
99,0
37,8
12,0
11/8
7,495
43,3
190
99,7
33,7
10,0
10
12/8
7,472
44,9
198,8
99,6
33,1
9,2
11
13/8
7,349
71,3
135,6
98,6
39,6
12,1
12
14/8
7,401
43,2
172,3
99,4
27,1
2,7
13
15/8
7,405
36,2
202,7
99,6
22,9
-0,9
14
16/8
7,392
39,2
178,3
99,4
24,0
-0,1
15
17/8
7,340
41,5
193,7
99,4
22,6
-2,3
16
18/8
7,442
41,4
89,4
97,2
28,5
4,6
Monitoring Hemodinamik
Hari Ke
-
MAP
66-112
CVP
(cmH2
O)
+11s/d+
18
Balanc
e 24
jam
- 232
III
IV
69-118
69-94
61-96
68-120
81 - 130
+5s/d+1
4,5
+5s/d+
11
+4s/d
+6
+4s/d
+14
+4s/d
+14
- 1426
1206,
3
-34,6
- 201
5238,2
3396,3
1,92
1,84
-1738
II
Balanc
e Kum.
- 232
- 1970
-4047,3
5253,
6
Urine
0,937
2,75
2,55
1,98
VI
VII
VIII
Monitoring Hemodinamik
Hari Ke -
IX
XI
XII
XIII
XIV
XV
MAP
64-105
61-113
51-135
60-111
61-96
60-120
66-112
CVP
(cmH2O)
+3,5s/d
+7
+6s/d+8
,5
+7,5s/d
+9
+5,5s/d
+9
+4s/d+
6
+2s/d+9
+11s/d
+18
Balance
24 jam
381,8
588,7
- 422,2
- 399,2
-1206,3
174,7
- 232
Balance
Kum.
- 4621,2
- 4032,5
- 4454,7
4853,9
-5253,6
-4679,2
- 232
Urine
1,33
1,1
2,04
1,87
1,98
1,21
0,937
15 AGUSTUS 2016
15 AGUSTUS 2016
2 AGUSTUS 2016
18 AGUSTUS 2016