Diagnosis dan Penatalaksanaan Ventilator-Associated Pneumonia - Anna Rozaliyani; Boedi Swidharmoko (Majalah Kedokteran UKI, 2010)
Abstrak Ventilator-associated pneumonia (VAP) atau pneumonia terkait penggunaan ventilator masih menjadi masalahdalam penatalaksanaan pasien pengguna ventilasi mekanis. Kejadian VAP dihubungkan dengan meningkatnyamorbiditas, lama rawat di rumah sakit atau ICU serta biaya yang harus dikeluarkan pasien. Etiologi VAP sangatbervariasi, hal itu berdasarkan atas populasi pasien, lama rawat di rumah sakit serta terapi antimikrobasebelumnya. Identifikasi segera pasien terinfeksi dan pemilihan antimikroba yang tepat berperan penting dalampenatalaksanaan. Pemilihan terapi antimikroba awal hendaknya didasarkan atas flora paling dominan yangbertanggungjawab terhadap terjadinya VAP pada tiap pusat perawatan, jenis ruang rawat, data laboratoriumpemeriksaan langsung bahan klinis paru, aktivitas antimikroba serta karakteristik farmakokinetiknya. Kata kunci : ventilator-associated pneumonia, diagnosis, penatalaksanaan, pemilihan antimikroba Abstract Ventilator-associated pneumonia (VAP) continues to complicate the management of patients receiving mechanical ventilation (MV). The VAP is associated with excess morbidity, increasing intensive care unit (ICU)/hospital stay and patient costs. The etiologic agents widely differ depend on the population of patients, duration of hospital stay and prior antimicrobial therapy. Rapid identification of the infected patients and accurate selection of the antimicrobial agents represent important clinical goals. Selection of the initial antimicrobial therapy should be based on the predominant flora responsible for VAP at each institution and clinical setting. Furthemore, the information provided by direct examination of pulmonary secretions. Finally, it should also be based on the antimicrobial agents activities and their pharmacokinetic characteristics. Keywords: ventilator-associated pneumonia, diagnosis, management, antimicrobial therapy