RESPON HORMON &

SITOKIN PADA LUKA

BAKAR
Andry Kelvianto
Firsandi Prasastya
Indah Bachti
Lidya Yudith
Melyarna Putri
Meriza Martineta
 Respon Metabolik (dalam Waktu) yang
Muncul akibat Adanya Stressor

Preiser JC, Ichai C, Orban JC, Groenoveld ABJ. Metabolic response to the stress of critical illness. BJA. 2014; 113 (6):
945-54.
 Respon Sistem Infeksi

Trauma Imun-neuroendokrin Leukosi

Akibat Luka Bakar t
Nosisepto
r perifer Sitokin

Aferen Medul Pon Hipotalamu Hipofisi

sensoris a s s s

Set Point

Kemoresept Baroresepto Adrena

or r Demam l
Hiposekmia Hipovole Korteks Medulla
Hiperkapnia mia
Shifting Aldoster Kortiso Adrenalin/
cairan on l Noradrenali
penguapan n
Retens
Preiser JC, Ichai C, Orban JC, Groenoveld ABJ. Metabolic response to Glukoneogenesi
the stress of critical illness. BJA. 2014; 113 (6): 945-54. i
s
(+): meningkat
(): menurun

Keterlibatan sitokin dalam respons tubuh terhadap injury

4
 Respon Imun & Sitokin
Severe burn injury

Bradikinin NF-KB Degranulasi sel

mast
1st
Hiperpermeabilita phase Mediator pro Histamin release
s pembuluh darah inflamasi
venular meningkat TNF , IL 6,
Makrofag Induced radikal
2nd bebas : ROS
Kerusakan tight Mediator anti
phase
junction endotel inflamasi

TH2, sitokin IL4

IL10, TGF

Nielson CB, et al. Burns:

Pathophysiology of Systemic
Complications and Current SIRS
Management. Journal of Burn
Respon Sistem Imun-neuroendokrin
Akibat Luka Bakar
Acute Phase Protein
Fase Metabolik akibat Adanya
Stres Berat
Fase Metabolik akibat Adanya Stres Berat
Perjalan
an Klinis
SIRS
Patofisiologi SIRS
 Kriteria SIRS
Ditandai 2 gejala sbb :
- Hipertermia/ hipotermia (>38.3 C /
<35.6C)
- Takipneu (RR > 20 kali/menit)
- Takikardia ( FN > 100 kali/menit)
- Leukositosis > 12.000/mm atau
leukopenia < 4000/mm
Rangel-Frausto, M . Ptett. Costingam M, et al. The natural history of
the systemic inflammatory response syndrome (SIRS). JAMA. 1995.
273:117-23