NEUROGENIC PULMONARY EDEMA: KOMPLIKASI YANG MENGANCAM JIWA AKIBAT KERUSAKAN BERAT SISTEM SARAF PUSAT
Abstract
ABSTRAK
Neurogenic Pulmonary Edema (NPE) adalah salah satu komplikasi akibat kerusakan berat sistem saraf pusat (SSP). Angka kejadiannya di dunia sekitar 2-8% dan masih jarang dilaporkan. Neurogenic pulmonary edema (NPE) biasa ditemukan pada kasus-kasus perdarahan intrakranial seperti SDH, SAH, dan ICH, pada kondisi epilepsi dan kejang berulang yang tidak terkontrol, serta pada beberapa kasus trauma medula spinalis. Patogenesis terjadinya Neurogenic Pulmonary Edema (NPE) belum dapat dipahami seutuhnya, tetapi terdapat 2 teori terjadinya Neurogenic Pulmonary Edema (NPE), yakni teori perubahan hemodinamik dan NPE trigger zone yang melibatkan pusat pengendalian otonom otak dan sistem kardiovaskular. Neurogenic Pulmonary Edema (NPE) memiliki onset akut dan kronik, yang ditandai dengan gejala menyerupai ARDS seperti dispnea, takipnea, takikardia, sputum bewarna kemerahan, ronki pada auskultasi, serta gambaran radiologi berupa gambaran diffuse alveolar infiltrat bilateral. Pengenalan tanda dan gejala Neurogenic Pulmonary Edema (NPE) sejak dini dapat memperbaiki keluaran pasien tersebut. Penanganan awal pada kondisi ini menggunakan 2 prinsip penatalaksanaan, yakni mengatasi kondisi underlying disease dan terapi suportif, seperti ventilator mekanik, ECMO. dan transpulmonary thermodilution, penggunaan diuretik, dan pengontrolan terapi cairan.
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References
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