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Gangguan Kognitif pada Diabetes Melitus

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Sepsis is aclinical syndrome as an overactive body respone to microorganismal prodct stimuli Mnifestations of fever, tachycardia, hypotension and organ malfunction are related with the cardiovascular problem level. The sepsis clinical signs is hyperthermia (>38,3ºC; 20/minute), tachycardia (pulse>100/minute), Leukocytosis (12.000/mm³) or leucopenia (>4.00/mm³, immature cell (10%), suspected infection and biomarker sign: PcT, CrP (ccm 2003) Septic shock as a subset, septic shoock is defined as septic-induced hypotension which is permanent even after fluid resuscitation, with tissue hypoperfusion. The septic shoock clinical signs are early phase signs (e.g volume depletion, dry mucosal layer, dry and humid skin), post fluid signs (hyperdynamic shock, e.g. tachycardia, hard hard wide arterial pulse, palpatory hyperdynamic precordium and warm extrimities) associated with sepsis manifestations and hiperfusion signs (e.g. Tachypneu, oliguria, cyanosis, motting, ischemic finger, mental change). In accordance with EGDT (Early Goal Directed Therapy0 Protocol, the early management covers by giving crystalloid colloid fluid replacements. The unresponsive patients to this fluid replacement, then, should be treated with vasoactive drugs. There is still debateful in determining the best vasoactive drugs used in septic shock. The main therapeutical target is the recovery of tissue perfusion by increasing the Mean Arterial Pressure (MAP) to 65 till 75 mmHg. The other needed is mucoardial contractility increase if it is appropriate and good tissue oxygen supply. Vasoconstrictors is strong enough to produce SVR and blood pressure increase without having at all effect on increasing arterial pulse, MAP increase at 65-75 mmHg, at the used dose of 47 µg/minute, maintaining the heart rate of 97-101/minute. Norepineprine is still potential for alpha-1 receptor agonist first choice management in septic shoock.

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Series Title

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Call Number

Dexa Media, 21(1):15-

Publisher

Jakarta : Tim Promosi Dexa Media Group., 2008

Collation

3p.

Language

ISBN/ISSN

0215-7551

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Subject(s)

diabetes mellitus
COGNITION DISORDERS

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