SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SffiS) PADA LUKA BAKAR - Muhammad Jailani (Universitas Syiah Kuala, 2005)
Abstrak. SIRS merupakan eksagerasi respons klinis terhadap cedera berat, hal yang umum terjadi pada Iuka bakar maupun cedera berat lainnya. Permasalahan akibat gangguan sirkulasi pada Iuka bakar demikian kompleks dan menjadi faktor utama penyebab timbulnya Systemic Inflammatory Response Syndrome (SIRS), sepsis dan Multi-system Organ Dysfunction (MODS). Manifestasi klinis SIRS yang paling umum adalah gangguan kesadaran, CHAOS, ARDS, ileus, gangguan hemeostasis, gangguan hemostatik (Disseminated Intravascular Coagulopathy, DIC), gangguan fungsi saluran cerna seperti diare dan enterokolitis. Sepsis (bakteremia, septikemia) adalah SIRS yang disebabkan infeksi. Sepsis terjadi karena : 1) translokasi bakteri, 2) infeksi Iuka dan 3) tindakan perawatan. MODS adalah fase akhir perjalanan SIRS; fungsi organ-organ sisternik terganggu dan berakhir dengan kegagalun menjalankan fungsi. Hal ini tcrjadi karena gangguan perfusi ke organ, kekacauan sisrim metabolisme dan peran destruktif beberapa mediator pro-inflamasi. Penatalaksanaan kasus Iuka bakar mengacu pada permasalahan yang ada/ timbul dengau strategi mengupayakan pencegahan berkembangnya kaskade SIRS dan MODS; atau memurus rantai kaskade yang sudah berjalan. (JKS 2005;1:27-39) Kata kunci : Luka bakar berat, SIRS, kaskade Abstract. SIRS is an enlargement of the clinical response to severe injury, it is common in burns or other serious injuries. Problems due to poor circulation of the burns are so complex and the main factor causing the Systemic Inflummatory Response Syndrome (SIRS). sepsis and multi-system organ dvsfunction (MODS). Clinical manilestcnions of SIRS is the most common disorder of consciousness. CHAOS, ARDS, ilcus. hcnieostasis disorders. he111os1C11ic disorders (Disseiuinated huravascular c·oagulopwhr, DIC). gastrointestinal , r. (t111c1io11 such (IS diarrhea and enterocolitis. Sepsis (bacteremia, septicemia) is SIRS caused by infection. Sepsis occurs because: I) translocation of bacteria, 2) wound infection and 3) maintenance actions. MODS is the final phase of the journey SIRS; systemic organ Ji111c1io11 becomes impaired and ended with a failure to execute thefunction. This happens due to organ perfusion disorder, metabolic system disorder and destructive role of multiple proinflammatory mediators. Burns case management refers to the existing problems with prevention efforts 011 the development of SIRS and MODS cascade; or decide cascade chain that is already running.(JKS 2005;/:27-39) Keywords: Severeburns. SIRS. cascade