Sindrom Infus Terkait Propofol: Diagnosis dan Penatalaksanaan
Tinjauan Pustaka
DOI:
https://doi.org/10.55175/cdk.v53i08.1747Kata Kunci:
Tata laksana PRIS, propofol, sindrom terkait infus propofol, asidosis laktat berat, asidosis metabolik beratAbstrak
Sindrom terkait infus propofol (PRIS), pertama kali dikenalkan pada tahun 1990, merupakan kondisi langka dan berbahaya disebabkan oleh pemberian propofol dosis tinggi (> 4 mg/kg/jam) yang berkepanjangan (> 48 jam) pada pasien yang menggunakan ventilasi mekanis. Kondisi ini ditandai dengan konstelasi gejala progresif yang melibatkan kegagalan multi-organ. Presentasi klinis utama meliputi asidosis metabolik dan laktat berat, rabdomiolisis, gagal hepar akut, darah lipemik, hiperkalemia, dan gangguan kardiovaskular atau bradikardia, yang dapat menyebabkan henti jantung. Mekanisme PRIS masih belum jelas dan kontroversial. Cara paling efektif untuk mencegah PRIS adalah dengan tetap waspada dan mempertahankan tingkat kecurigaan yang tinggi selama pemberian propofol dalam jangka waktu lama. Pengenalan dini terhadap manifestasi klinis PRIS, penghentian segera pemberian propofol, serta pemberian terapi suportif yang tepat sangat penting untuk menurunkan morbiditas dan mortalitas. Pemahaman mengenai faktor risiko serta mekanisme patofisiologi PRIS diharapkan dapat membantu klinisi dalam melakukan deteksi dini dan pencegahan komplikasi pada pasien kritis yang mendapatkan infus propofol berkepanjangan.
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