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Abstract

Tetralogy of Fallot (TOF) is a congenital heart defect that causes chronic low oxygen levels, increased right ventricular workload, and a higher risk of complications. Weaning mechanical ventilation in patients with TOF is particularly challenging due to right ventricular dysfunction, muscle weakness, and the risk of heart failure. This study evaluates the use of a spontaneous breathing trial (SBT) strategy with pressure support ventilation (PSV) mode for mechanical ventilation weaning in pediatric patients with TOF. An observational study was conducted on a six-year-old pediatric patient with TOF and a cerebral abscess who underwent mechanical ventilation weaning using the SBT technique with PSV mode. The patient’s vital signs (heart rate and respiratory rate) and oxygen saturation were monitored 24 h before, during, and 24 h after the trial. Weaning was successfully completed within 11 h without signs of failure, such as hypoxemia or muscle fatigue. The rapid shallow breathing index measured prior to weaning was within an acceptable range. The patient’s physiological parameters remained stable throughout the process, and no Tet spells were observed. These findings suggest that SBT combined with PSV mode is a viable weaning strategy in pediatric TOF cases, particularly when a longer trial duration is used. However, because this report is based on a single case, the results should be interpreted with caution and cannot be generalized to all patients with TOF.

Bahasa Abstract

Penyapihan Ventilator dengan Teknik Spontaneous Breathing Trial pada Anak dengan Tetralogy of Fallotdi Ruang PICU: Studi Kasus. Tetralogy of Fallot (TOF) adalah kelainan jantung bawaan yang menyebabkan kadar oksigen rendah kronis, beban kerja pada ventrikel kanan meningkat, dan risiko komplikasiyang lebih tinggi. Penyapihan ventilasi mekanis pada pasien dengan TOF sangat menantang karena adanya disfungsi ventrikel kanan, kelemahan otot, dan risiko gagal jantung. Studi ini mengevaluasi penggunaan strategi Spontaneous Breathing Trial (SBT) dengan mode Pressure Support Ventilation (PSV) dalam proses penyapihan ventilasi mekanis pada pasien anak dengan TOF. Sebuah studi observasional dilakukan pada pasien anak berusia enam tahun dengan TOF dan cerebral abscess yang menjalani penghentian penggunaan ventilasi mekanis menggunakan teknik SBTdengan mode PSV. Tanda-tanda vital pasien (denyut jantungdan laju pernapasan) dan saturasi oksigen dipantau 24 jam sebelum, selama, dan 24 jam setelah uji coba. Penyapihan ventilasi mekanis berhasil diselesaikan dalam 11 jam tanpa tanda-tanda kegagalan, seperti hipoksemia atau kelelahan otot. Nilai rapid shallow breathing index yang diukur sebelum penyapihan berada dalam rentang yang dapat diterima. Selama proses penyapihan, prameter fisiologis pasien tetap stabil dan tidak ada Tet spellsyang diamati. Temuan ini menunjukkan bahwa penggunaan SBTdengan mode PSVdapat menjadi strategi penyapihan ventilator yang layak pada kasus TOF pediatrik, terutama saat menggunakan durasi uji coba yang lebih lama. Namun, karena laporan ini hanya berdasarkan satu kasus, hasilnya harus ditafsirkan dengan hati-hati dan tidak dapat digeneralisasi untuk semua pasien dengan TOF.

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