Tatalaksana Sepsis Berat pada Pasien Lanjut Usia

  • Indah Sapta Wardani Fakultas Kedokteran Universitas Mataram


Sepsis adalah permasalahan yang memiliki mortalitas dan morbiditas yang tinggi terutama pada orang lanjut usia. Usia tua merupakan faktor predisposisi sepsis yang disebabkan adanya komorbiditas, pemanjangan dan berulangnya rawat inap, penurunan imunitas serta keterbatasan fungsional yang semuanya disebabkan faktor penuaan itu sendiri. Diagnosis sepsis pada lansia lebih sulit, karena lansia memberikan respon dan gejala klinis sepsis yang kurang jelas. Tatalaksana sepsis berat pada lansia secara cepat dan tepat sangat diperlukan untuk memberikan terapi yang optimal.


1. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Critical care medicine. 2001;29(7):1303–1310.

2. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal MS, et al. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock: 2012. Critical Care Medicine and Intensive Care Medicine. 2013;41(2):580–637.

3. Martin GS, Mannino DM, Moss M. The effect of age on the development and outcome of adult sepsis. Critical care medicine. 2006 Jan;34:15–21.

4. Girard TD, Opal SM, Ely EW. Insights into severe sepsis in older patients: from epidemiology to evidence-based management. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2005 Mar;40:719–727.

5. Herring AR, Williamson JC. Principles of antimicrobial use in older adults. Clinics in geriatric medicine. 2007 Aug;23:481–97, v.

6. Kumar A, Safdar N, Kethireddy S, Chateau D. A survival benefit of combination antibiotic therapy for serious infections associated with sepsis and septic shock is contingent only on the risk of death: a meta-analytic/meta-regression study. Critical care medicine. 2010 Aug;38:1651–1664.

7. Levy MM, Dellinger RP, Townsend SR, LindeZwirble WT, Marshall JC, Bion J, et al. The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Critical care medicine. 2010 Feb;38:367–374.

8. Nasa P, Juneja D, Singh O, Dang R, Arora V. Severe sepsis and its impact on outcome in elderly and very elderly patients admitted in intensive care unit. Journal of intensive care medicine. 2011;27:179–183.

9. Marik PE. Management of the critically ill geriatric patient. Critical care medicine. 2006 Sep;34:S176–S182.

10. Sligl W, Danny A Milner J, Sundar S, Mphatswe W, Majumdar S. Safety and Efficacy of Corticosteroids for the Treatment of Septic Shock: A Systematic Review and Meta-Analysis. 2009;49:93–101.

11. Martin C, Viviand X, Leone M, Thirion X. Effect of norepinephrine on the outcome of septic shock. 2000;28:2758–2765.

12. Arabi ea Yaseen M. Intensive versus Conventional Insulin Therapy: A Randomized Controlled Trial in Medical and Surgical Critically Ill Patients. Critical Care Medicine. 2008;36(12):3190–3197.

13. Marik PE, Vasu T, Hirani A, Pachinburavan M. Stress ulcer prophylaxis in the new millennium: A systematic review and meta-analysis. 2010;38:2222–2228.
Literature Review