Peran Ultrasonografi dalam Diagnosis Pneumotoraks pada Kasus Henti Jantung: Laporan Kasus

• Main Author: Susilo Chandra
• Format: Article
• Language: English
• Published: Universitas Indonesia 2019-09-01
• Series: Journal Kedokteran Indonesia
• Online Access: http://journal.ui.ac.id/index.php/eJKI/article/view/10776

<p class="Pa29" style="margin-right: 1.3pt; text-align: justify;"><span style="font-size: 8pt;">Mesin ultrasonografi (USG) saat ini telah berkembang menjadi lebih ringkas dan mudah dibawa sehingga membuat evaluasi cepat pada pasien dengan keadaan tidak stabil lebih mudah dilakukan. USG memiliki sensitivitas tinggi dibandingkan foto polos toraks dalam deteksi pneumotoraks. Pada laporan kasus ini yang terjadi di Rumah Sakit Umum Pusat Nasional (RSUPN) Cipto Mangunkusumo pada bulan November 2018 hendak menggambarkan peran penting USG dalam deteksi dini pneumotoraks. Bayi laki-laki berusia 4 bulan dengan tumor di regio palatum dijadwalkan untuk menjalani eksisi tumor elektif. Pasien memiliki riwayat code blue karena trakeostomi yang bergeser. Pasien mengalami desaturasi intraoperatif dari 100% hingga 80% hingga bradikardia dan akhirnya henti jantung. Dengan menggunakan USG yang diletakkan di hemitoraks kanan dan kiri dapat menemukan bahwa lung sliding tidak ada di paru sebelah kanan. Dengan keadaan pasien yang tidak stabil, dilakukan needle thoracosyntesis dengan jarum 14 Gauge pada celah interkostae kedua sejajar garis midklavikula. Sirkulasi spontan kembali dan saturasi oksigen meningkat hingga 100%. </span><span style="font-size: 8pt;"></span></p> <p class="Pa28" style="margin-right: 1.3pt; text-align: justify;"><strong><span style="font-size: 9pt;">Kata kunci: </span></strong><span style="font-size: 9pt;">Ultrasonografi, pneumotoraks, hemitoraks </span><span style="font-size: 9pt;"></span></p> <p class="Pa74" style="margin-right: 1.3pt;"><strong><span style="font-size: 11.5pt;"><br /> The Role of Ultrasound in Pneumothorax Diagnosis in Cardiac Arrest Patient </span></strong><span style="font-size: 11.5pt;"></span></p> <p class="Pa28" style="margin-right: 1.3pt; text-align: justify;"><strong><span style="font-size: 9pt;">&nbsp;</span></strong></p> <p class="Pa28" style="margin-right: 1.3pt; text-align: justify;"><strong><span style="font-size: 9pt;">Abstract </span></strong><span style="font-size: 9pt;"></span></p> <p class="Pa29" style="margin-right: 1.3pt; text-align: justify;"><span style="font-size: 8pt;">As ultrasound machines have become more portable and easier to use, thus allows a rapid evaluation of an unstable patient, at the bedside. Ultrasound has a higher sensitivity than the traditional upright anteroposterior chest radiography for the detection of a pneumothorax. In this report which happened on November 2018 in Cipto Mangunkusumo Hospital would like to highlight the use of ultrasound to detect pneumothorax. A four-months old baby boy with tumor in palatum region was scheduled to undergo elective tumor excision. This patient also with history of code blue because of tracheostomy displacement. After surgery the patient&rsquo;s oxygen saturation gradually decreased from 100% into the low 80s until bradycardia and cardiac arres. Using ultrasound, the right and left hemithoraces were examined. The ultrasound probe was placed on the anterior chest wall at multiple intercostal spaces. Lung sliding was demonstrated on the left lung after the exam, but not on the right lung. Because of the patient&rsquo;s unstable condition, a 14-gauge intravenous catheter was placed superior to the rib at the second intercostal space along the midclavicular line. An immediate return of spontaneous circulation resulted. A chest tube was placed, and the patient&rsquo;s oxygen saturation returned to 100%. </span><span style="font-size: 8pt;"></span></p> <p class="MsoNormal" style="margin-right: 1.3pt;"><strong><span style="font-size: 9pt; line-height: 107%;">Keywords: </span></strong><span style="font-size: 9pt; line-height: 107%;">Ultrasound machines, pneumothorax, hemithorax.</span></p><!--[endif] -->