Syok Hipovolemik

Dr. Az Rifki, SpAn.KIC

SMF/Bag Anestesiologi dan ICU
RSI Siti Rahmah/FK Universitas Baiturrahmah
Padang
 Definisi
 Gangguan sistem sirkulasi
 Tidak adekuatnya aliran darah ke
jaringan
 Tidak adekuatnya perfusi dan
oksigenasi ke jaringan

Shock is a major critical illness that involves almost every

organ system. It is not simply a problem of decreased blood
pressure. Rather, it is a problem of inadequate tissue perfusion
(Rice,1991)
 Definisi

• Hipotensi
– Tekanan Darah Sistolik < 90 mmHg
– Tekanan Darah Sistolik berkurang > 40 mmHg
• Hipoperfusi
– Perubahan status mental
– Oliguria
– Asidosis laktat
 Sistem Kardiovaskuler

 Pompa jantung

 Volume sirkulasi

 Tahanan pembuluh

darah perifer
Pembagian Syok

• Kardiogenik

• Hipovolemik

• Distributif

• Obstruktif
 Tanda dan gejala syok

 Sistem Kardiovaskuler
 Gangguan sirkulasi
 Pucat,dingin, sianosis
 Vena perifer kolaps

 Nadi cepat dan halus

 Tekanan darah rendah – kurang bisa jadi
pegangan
 Vena jugularis – penting.
 CVP
 Tanda dan gejala syok

 Sistem Respirasi
 Nafas cepat dan dangkal
 Sistem susunan saraf pusat
 Perubahan mental / kesadaran
 Sistem saluran cerna
 Mual dan muntah
 Sistem saluran kencing
 Produksi urin < ½ cc/kg/jam
 HYPOVOLEMIC SHOCK
 Hypovolemic shock is insufficient or inadequate circulating blood
throughout the body
 is characterised by a decrease in circulating intravascular volume.
 The most common causes of hypovolemic shock are
hemorrhage, burns, dehydration.
 Hypovolemic shock occurs when plasma volume is inadequate and
the body's compensatory mechanisms are no longer able to
compensate for the fluid loss.
 Signs of hypovolemic shock may be seen when the total circulating
blood volume has been diminished by 15-20%, which equals
approximately 500ml - 1500ml of circulating blood
 Penanganan Syok Hipovolemik

• Mengembalikan volume intravaskuler

– Tekanan Darah
– Nadi
– Perfusi organ
• Pilihan cairan
– Kristaloid
– Koloid
– PRC
Penanganan Syok Hipovolemik

 Pasang jalur IV satu/lebih no. 18 / 16

 Infus cepat Kristaloid / kombinasi+koloid
 Bila perdarahan, ambil contoh darah
 Bila vena sudah terisi, peningkatan isi nadi
dan tekanan darah, infus lambatkan
 Jangan kelebihan cairan
 Terapi Cairan

• Mengganti volume intravaskuler

• Menentukan status volume cairan pasien

– Vena leher

– Auskultasi paru
 Resusitasi Cairan

• Koreksi hipotensi
• Turunkan HR
• Koreksi hipoperfusi
– Oliguria
– Perubahan status mental
– Asidosis laktat
• Pantau perburukkan oksigenasi