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"Latar belakang: Mekanisme penyebab kematian COVID-19 adalah terjadinya hipoksemia dan ARDS. Salah satu komponen dalam penilaian ARDS adalah hasil Annalisis Gas Darah (AGD) dan nilai perbedaan tekanan parsial oksigen di arteri dan alveolus yang dikenal sebagai AaDO2. Peran nilai analisis gas darah dan AaDO2 pada luaran meninggal COVID-19 perlu di telaah lebih lanjut.Metode penelitian: Analisis deskriptif kohort retrospektif terhadap pasien COVID-19 terkonfirmasi yang dirawat di RSUP Persahabatan secara consecutive sampling dari bulan maret sampai dengan agustus 2020. Kami meninjau 205 rekam medis pasien terkonfirmasi yang telah memenuhi kriteria inklusi.Hasil: Median dan rentang nilai pH, PaCO2, PaO2, HCO3, BE, SaO2, FiO2, SpO2 adalah 7,41(7,01-7,54), 32,1(17,5-87,1), 73,9(22,7-343,7), 21(7,2-38,9), -3,8(-22,2-13,3), 94,9(33,5-99,9), 0,54(0,21-1,00), 95(33,5-99,9) secara berurutan. Terapi oksigen yang digunakan pasien adalah masker oksigen nonhirup ulang sebesar 37,56% diikuti dengan kanula hidung sebesar 32,20%, ventilator mekanis sebesar 16,59%, kanula hidung arus tin ggi sebesar 10,73%, masker sederhana sebesar 0,98% dan masker venturi sebesar 0,49%. Median nilai AaDO2 sebesar 272,58% (40,55-644,17). Derajat penyakit klinis terbanyak memiliki derajat klinis kritis sebesar 93,2%. Gangguan asam basa yang dialami pasien adalah 33,51% mengalami gangguan asam basa campuran, 22% mengalami gangguan asidosis metabolik tidak terkompensasi dan 25% pasien mengalami asidosis repiratorik terkompensasi. Terdapat korelasi parameter PaO2, BE, SaO2, FiO2, PAO2 dan AaDO2 dengan kejadian kematian pasien (p<0,05).

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Background: The cause of death in COVID-19 is hypoxemia in acute respiratory distress syndrome (ARDS). This condition could be assessed through arterial blood gas analysis by determining the alveolar arterial oxygen gradient value (AaDO2). The role of arterial blood gas analysis and AaDO2 to predict mortality in COVID-19 is yet to be explored.

Methods: We performed observational retrospective cohort analysis of COVID-19 confirmed patients treated at Persahabatan Hospital, Jakarta, Indonesia. Subject by means of consecutive sampling were COVID-19 confirmed patients between March and August 2020. We reviewed the medical record of 205 patients whom meet the inclusion criteria.

Results: Median value and range of pH, PaCO2, PaO2, HCO3, BE, SaO2, FiO2, SpO2 were 7.41(7.01-7.54), 32.1(17.5-87.1), 73.9(22.7-343.7), 21(7.2-38.9), -3.8(-22.2-13.3), 94.9(33.5-99.9), 0.54(0.21-1.00) and 95(33.5-99.9). Most of the patients use non-rebreathing mask (37.56%), followed by nasal cannula (32.2%), mechanical ventilator (16.59%), high flow nasal cannula (10.73%), simple mask (0.98%) and venturi mask (0.49%). Median value of AaDO2 was 272.58 (40.55-644.17). Most of the patients were critically ill (93.2%). There were 33.51% patients presented with the mix acid base disorder, 22% with uncompensated metabolic acidosis disorder and 25% with compensated respiratory acidosis disorder. There was a correlatio"

"Latar Belakang: Penggunaan heparin inhalasi pada beberapa penelitian COVID-19memberikan hasil dalam perbaikan klinis pasien, baik dalam menurunkan lama rawat,perbaikan oksigenasi paru, dan mortalitas. Dosis harian total heparin inhalasi yangbervariasi terutama bila diberikan bersamaan dengan antikoagulan sistemik, memilikiresiko komplikasi perdarahan yang memerlukan kajian terhadap keefektifan dankeamanannya.Tujuan: Meneliti keefektifan dan keamanan inhalasi heparin dosis 150,000 IU/haridengan dosis 100.000 IU/hari dinilai dari AaDO2, aPTT dan d-Dimer dalam 7 haripengamatan pada pasien ICU COVID-19.Metode: Penelitian ini merupakan penelitian observasional dengan studi kohortretrospektif menggunakan data sekunder rekam medis pasien ICU COVID-19 bulanSeptember 2020 – September 2021. Terdapat 300 sampel menggunakan consecutivesampling. Pasien dikelompokkan menjadi kelompok heparin dosis 150.000 IU/hari dan100.000 IU/hari. Pencatatan dilakukan dalam 7 hari pengamatan. Uji Statistikmenggunakan uji Mann Whitney untuk menilai tingkat keparahan, Uji Wilcoxon rank testuntuk melihat perbedaan variabel dependen hari pertama dengan hari ketujuh padamasing-masing dosis.Hasil: Heparin inhalasi baik dosis 150.000 IU/hari dan 100.000 IU /hari bermaknamenurunkan AaDO2 pada 7 hari pengamatan (p 0.001). Nilai aPTT tidak memanjangpada kedua kelompok, dan kedua dosis heparin sama- sama menurunkan nilai d-Dimerpada 7 hari pengamatan (p 0.001).Simpulan: Heparin Inhalasi dosis 150.000 IU/hari sama efektif dinilai dari AaDO2, dansama amannya terhadap aPTT dan d-Dimer dibandingkan heparin inhalasi dosis 100.000IU/hari.

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Rationale: The use of inhaled heparin in several COVID-19 studies has resulted in

clinical improvements in patients, both in reducing length of treatment, improving

pulmonary oxygenation, and reducing mortality. The varying total daily dose of inhaled

heparin, especially when given together with systemic anticoagulants, poses a risk of

bleeding complications that require review of its effectiveness and safety.

Objective: To analyze effectiveness and safety of heparin inhalation dosage 150,000

IU/day compare to 100,000 IU/day assessed from AaDO2, aPTT and d-Dimer from 7

days observation in ICU COVID-19 patients with invasive and non-invasive ventilator

patterns.

Methods: An observational cohort retrospective study used secondary data from medical

records ICU COVID-19 patients with invasive and noninvasive ventilator patterns from

September 2020 – September 2021. There were 300 samples using consecutive sampling.

Patients divided into 2 groups, one received dosage 150,000 IU / day heparin inhalation,

the other received heparin inhalation dosage 100,000 IU / day. Recording of the research

from medical records is carried out at 7 days of ICU treatment. Statistical tests were

carried out using Mann Whitney to assess severity, Wilcoxon rank test to see the

difference in dependent variables day 1 and day 7 to dose.

Measurements and Main Results: Heparin inhalation at dose of 150,000 IU/day and

100,000 IU/day both significantly decreased AaDO2 at 7 days of observation (p 0.001).

The aPTT on both groups at 7 days of observation are within normal limits. Both doses

of heparin inhalation decreased d-dimer at 7 days of observation (p 0.001).

Conclusion: Inhaled heparin doses of 150,000 IU/day as effective and as safe as inhaled

heparin doses of 100,000 IU/day."