Abstract THE DIFFERENCE OF BIOELECTRICAL IMPEDANCE ANALYSIS BIA VALUE
PARAMETER IN THE SEPSIS MALE PATIENT WITH HIV AND SEPSIS WITHOUT HIV INFECTION
T. Iskandar Rizal, Franciscus Ginting, Armon Rahimi
Division of Tropical Medicine, Departement of Internal Medicine Faculty of Medicine, Sumatera Utara University, Medan
Background : Sepsis occurs by severe infection complication with systemic inflammation character and wide lesion over the tissue. The incidency and mortality of sepsis is quite high especially in HIV
infection patient. Sepsis in the patient with HIV or without HIV infection would impact alteration in the body composition according to the difference of severity level. The alteration of body composition
may be evaluated by BIA which it would assess of the nutritional state, the body fluid state and phase angle as the severity level indicator so it would be expected to be useful for management sepsis in the
future.
Aim : To understand difference of BIA value parameter among the sepsis male patient with or without HIV infection.
Methode : The study was conducted as cross-sectional design between July until September 2011 at RSUP H Adam Malik Medan. Subjects were recruted in two male groups i.e. HIV sepsis and without-
HIV sepsis, and the age was between 20 and 60 years old. Sepsis was established by SIRS with blood culture and procalsitonin while HIV infection was established by three-methode of ELISA. Then
evaluation was done by BIA, the calculation result would be appeared automatically. The normal distribution of data would be analysed by independent t test, while the abnormal one would be
analysed by Mann-Whitney test, it was statistically significant if P value of 0.05.
Result : There were 42 samples which was consisted of 21-HIV sepsis patients and 21-without HIV sepsis patients. The baseline characteristics of both groups i.e. : age 29.5±5.8 and 43.6±13.2 years
old, body weight 49.2±6.5 and 60.0±8.2 kg, BMI 17.8±2.2 and 22.1 ±3.2 kgm
2
, respectively, the etiology of sepsis was not different significantly in two groups. There was significantly different of
nutritional state parameter which HIV sepsis group was lower than another one : BCM 19.5±2.9 vs 24.0±3.7 kg, FFM 43.6±5.8 vs 49.5±6.4 kg, FM 5.6±2.2 vs 10.4±6.1 kg, FM 11.3±4.1 vs
16.9±7.8 , muscle 19.3±3.0 vs 22.7±2.8 kg and glicogen 395.7±53.1 vs 450.5±57.9 g, respectively. There was only FFM higher in HIV sepsis group 88.7±4.1 vs 83.1±7.8 . Body
fluid volume was also significantly different which HIV sepsis group was lower than another one : TBW 30.1±4.0 vs 35.9±6.4 litres, ICW 10.9±3.1 vs 15.5±4.6 litres, ICW 36.8±11.0 vs
43.6±10.8 , and TBK 94.5±13.9 vs 115.9±17.7 g, respectively. There was only ECW higher in HIV sepsis group 63.1±11.0 vs 56.4±10.8 . Parameter of phase angle was also significantly
different which it was lower in HIV sepsis group than another one 3,4±1,0 vs 4,4±1,9
Conclusion : There was significantly different of nutritional state, body fluid volume and phase angle which it was measured by BIA and the result was lower in HIV sepsis patient than without HIV one.
There was only FFM and ECW higher in HIV sepsis group. .
Key words : Sepsis, HIV, BIA, Nutritional state, Body fluid volume, Phase angle.
Universitas Sumatera Utara
Abstrak PERBEDAAN NILAI PARAMETER BIOELECTRICAL IMPEDANCE ANALYSIS BIA
PADA PASIEN PRIA SEPSIS HIV DAN NON HIV T. Iskandar Rizal, Franciscus Ginting, Armon Rahimi
Divisi Penyakit Tropis dan Infeksi, Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Sumatera Utara, Medan
Latar belakang : Sepsis terjadi akibat komplikasi infeksi berat dengan karakteristik inflamasi sistemik dan jejas pada jaringan yang luas. Insidensi dan mortalitas sepsis sangat tinggi, terutama
pada pasien dengan infeksi HIV. Sepsis pada infeksi HIV atau non HIV akan menyebabkan perubahan pada komposisi tubuh dalam tingkat keparahan yang berbeda. Perubahan komposisi tubuh
dapat dievaluasi dengan menggunakan BIA, yang dapat menilai status nutrisi, status cairan tubuh, dan phase angle sebagai indikator keparahan penyakit, sehingga diharapkan bermanfaat untuk tatalaksana
pasien sepsis ke depan.
Tujuan : Untuk mengetahui perbedaan nilai parameter BIA antara pasien pria sepsis pada infeksi HIV dengan sepsis pada non HIV
Metode : Penelitian dilakukan secara potong lintang mulai Juli – September 2011 di RSUP H.Adam Malik Medan dengan subjek penelitian kelompok sepsis HIV dan non HIV, jenis kelamin pria, usia
20-60 tahun. Sepsis ditegakkan berdasarkan SIRS ditambah kultur darah dan prokalsitonin, infeksi HIV ditegakkan dengan ELISA 3 metode. Kemudian dilakukan pemeriksaan dengan alat BIA, hasil
kalkulasi akan keluar otomatis. Data berdistribusi normal dianalisa memakai uji t tidak berpasangan, yang tidak berdistribusi normal memakai Mann-Whitney test, dikatakan bermakna bila P 0,05.
Hasil : Dari 42 sampel, terdiri atas 21 orang sepsis HIV dan 21 orang sepsis non HIV. Karakteristik dasar kelompok sepsis HIV dan non HIV: umur 29,5±5,8 dan 43,6±13,2 tahun, berat badan
49,2±6,5 dan 60,0±8,2 kg, IMT 17,8±2,2 dan 22,1 ±3,2 kgm
2
, diagnosis etiologi sepsis antara kedua kelompok tidak berbeda bermakna. Dijumpai perbedaan bermakna parameter status nutrisi,
dimana kelompok sepsis HIV lebih rendah dibanding non HIV: BCM 19,5±2,9 vs 24,0±3,7 kg, FFM 43,6±5,8 vs 49,5±6,4 kg, FM 5,6±2,2 vs 10,4±6,1 kg, FM 11,3±4,1 vs 16,9±7,8 , muscle
19,3±3,0 vs 22,7±2,8 kg, dan glikogen 395,7±53,1 vs 450,5±57,9 g. Hanya FFM yang nilainya lebih tinggi pada kelompok sepsis HIV 88,7±4,1 vs 83,1±7,8 . Status volume cairan tubuh juga
berbeda bermakna, dimana parameter kelompok sepsis HIV lebih rendah dibanding non HIV: TBW 30,1±4,0 vs 35,9±6,4 liter, ICW 10,9±3,1 vs 15,5±4,6 liter, ICW 36,8±11,0 vs 43,6±10,8 ,
dan TBK 94,5±13,9 vs 115,9±17,7 g. Hanya ECW yang nilainya lebih tinggi pada sepsis HIV 63,1±11,0 vs 56,4±10,8 . Parameter phase angle juga berbeda bermakna, dimana pada sepsis HIV
lebih rendah dibanding non HIV 3,4±1,0 vs 4,4±1,9
Kesimpulan : Terdapat perbedaan bermakna parameter status nutrisi, volume cairan tubuh, dan phase angle yang diukur dengan BIA, dimana nilai pada kelompok sepsis HIV lebih rendah dibanding
non HIV. Hanya FFM dan ECW yang nilainya lebih tinggi pada kelompok sepsis HIV. .
Kata kunci : Sepsis, HIV, BIA, status nutrisi, status volume cairan tubuh, phase angle.
Universitas Sumatera Utara
Abstract THE DIFFERENCE OF BIOELECTRICAL IMPEDANCE ANALYSIS BIA VALUE
PARAMETER IN THE SEPSIS MALE PATIENT WITH HIV AND SEPSIS WITHOUT HIV INFECTION
T. Iskandar Rizal, Franciscus Ginting, Armon Rahimi
