Kondisi vegetatif persisten

Kondisi vegetatif persisten
Kondisi vegetatif persisten
Informasi umum
Spesialisasi	Neurologi

Kondisi vegetatif persisten (persistent vegetative state, PVS) adalah kelainan kesadaran di mana pasien dengan kerusakan otak serius berada dalam kondisi sadar secara parsial namun tidak menunjukan persepsi dan reaksi kognitif terhadap rangsangan yang ada di sekitarnya. Vegetatif memiliki makna tidak aktif secara fisik.^[1] Pasien yang memperlihatkan kondisi vegetatif selama lebih dari empat minggu dinyatakan persisten, dan setelah satu tahun dinyatakan permanen.^[2]

Definisi

Kondisi bangun namun tidak sadar yang berlangsung selama lebih dari beberapa hari dapat disebut sebagai PVS.^[3] Tidak seperti kematian otak, PVS dapat secara hukum disebut dengan kematian di berbagai sistem hukum. Di Amerika Serikat dan Inggris, pengadilan dapat memberikan petisi sebelum pemutusan sistem penyokong kehidupan (life support) ketika diketahui bahwa pengembalian fungsi kognitif pada kondisi vegetatif pasien dinilai tidak memungkinkan.^[4]

Kondisi tidak jelas antara hidup dan mati ini telah memunculkan usulan bahwa pasien yang berada dalam kondisi PVS seharusnya diizinkan untuk meninggal. Yang lainnya menyatakan bahwa, jika proses penyembuhan masih memungkinkan, maka perawatan harus dilanjutkan. Jumlah kasus pasien PVS yang sembuh kembali tergolong kecil sehingga menentukan antara "mungkin atau tidak mungkin" pasien dapat disembuhkan kembali sulit ditentukan secara hukum.^[5] Hal ini menjadi masalah secara hukum dan etika karena menyangkut kebebasan pasien, kualitas hidup, penggunaan sumber daya, keinginan keluarga, dan tanggung jawab profesi kedokteran.

Pasien PVS ternama

Pasien dengan kondisi PVS terlama dan selamat adalah Elaine Esposito,^[6] yang berada dalam kondisi PVS selama 37 tahun 111 hari sejak tahun 1941 sampai 1978.^[7]

Catatan kaki

^ en:wikt:vegetative
^ The Multi-Society Task Force on PVS (1994). "Medical Aspects of the Persistent Vegetative State— Second of Two Parts". New England Journal of Medicine. 330 (22): 1572–9. doi:10.1056/NEJM199406023302206. PMID 8177248.
^ The Multi-Society Task Force on PVS (1994). "Medical Aspects of the Persistent Vegetative State— First of Two Parts". New England Journal of Medicine. 330 (21): 1499–1508. doi:10.1056/NEJM199405263302107. PMID 7818633.
^ Jennett, B (1999). "Should cases of permanent vegetative state still go to court?. Britain should follow other countries and keep the courts for cases of dispute". BMJ (Clinical research ed.). 319 (7213): 796–7. PMC 1116645 . PMID 10496803.
^ Diagnosing The Permanent Vegetative State by Ronald Cranford, MD
^ Lamb, D. (1985). Death, Brain Death and Ethics. Albany: SUNY Press. hlm. 6. ISBN 978-0-88706-121-9.
^ Ronald E. Cranford (1984). "Termination of Treatment in the Persistent Vegetative State". Seminars in Neurology. 4 (1): 36–44. PMID 11649666.

Referensi

Borthwick C (1996) The permanent vegetative state: ethical crux, medical fiction? Diarsipkan 2009-10-16 di Wayback Machine. Issues Law Med. 1996 Fall;12(2):167-85. The author questions the validity of most PVS diagnoses, and the validity of the basic nosology. The fulltext is available on the author's website.
Laureys, Steven (2000). "The neural correlate of (un)awareness: lessons from the vegetative state". Cyclotron Research Center and Department of Neurology. B30.
Matsuda, W.; Matsumura, A.; Komatsu, Y.; Yanaka, K.; Nose, T (2003). "Awakenings from persistent vegetative state: report of three cases with Parkinsonism and brain stem lesions on MRI". Journal of Neurology, Neurosurgery and Psychiatry. 74 (11): 1571–3. doi:10.1136/jnnp.74.11.1571. PMC 1738238 . PMID 14617720.
Owen, A.M.; Menon, D.K.; Johnsrude, I.S.; Bor, D.; Scott, SK; Manly, T; Williams, EJ; Mummery, C; Pickard, JD (2002). "Detecting residual cognitive function in persistent vegetative state". Neurocase. 8 (5): 394–403. doi:10.1076/neur.8.4.394.16184. PMID 12499414.
Boly, M.; Faymonville, ME; Peigneux, P; Lambermont, B; Damas, P; Del Fiore, G; Degueldre, C; Franck, G; Luxen, A (2004). "Auditory Processing in Severely Brain Injured Patients". Arch Neurol. 61 (2): 233–238. doi:10.1001/archneur.61.2.233. PMID 14967772.
Emmett, P. A. (1989). "A Biblico-Ethical Response to the Question of Withdrawing Fluid and Nutrition from Individuals in the Persistent Vegetative State". 4–5: 248–249.
Ashwal, S. (1994). "Medical Aspects of the Persistent Vegetative State— Second of Two Parts". N Engl J Med. 330 (22): 1572–1579. doi:10.1056/NEJM199406023302206. PMID 8177248.
Owen, A.M.; Coleman, M.R.; Johnsrude, I.S.; Menon, D.K.; Rodd, JM; Davis, MH; Taylor, K; Pickard, JD (2005). "Residual auditory function in persistent vegetative state: A combined PET and fMRI study". Neuropsychological Rehabilitation. 15 (3–4): 290–306. doi:10.1080/09602010443000579. PMID 16350973.
Laureys, S.; Faymonville, M.E.; Peigneux, P.; Menon, D.K.; Lambermont, B; Del Fiore, G; Degueldre, C; Aerts, J; Luxen, A (2002). "Cortical processing of noxious somatosensory stimuli in the persistent vegetative state". Neuroimage. 17 (2): 732–741. doi:10.1016/S1053-8119(02)91236-X. PMID 12377148.
Sara, M.; Sacco, S.; Cipolla, F.; Onorati, P.; Scoppetta, C; Albertini, G; Carolei, A (2007). "An unexpected recovery from permanent vegetative state". Brain Injury. 21 (1): 101–103. doi:10.1080/02699050601151761. PMID 17364525.
Schiff, N.D.; Ribary, U.; Moreno, D.R.; Beattie, B.; Kronberg, E; Blasberg, R; Giacino, J; McCagg, C; Fins, JJ (2002). "Residual cerebral activity and behavioural fragments can remain in the persistently vegetative brain". Brain. 125 (Pt 6): 1210–1234. doi:10.1093/brain/awf131. PMID 12023311.
<Please add first missing authors to populate metadata.> (1996). "Diagnosis and management: Report of a working party of the Royal College of Physicians". Royal College of Physicians.
Canavero S; et al. (2009). "Recovery of consciousness following bifocal extradural cortical stimulation in a permanently vegetative patient". Journal of Neurology. 256 (5): 834–6. doi:10.1007/s00415-009-5019-4. PMID 19252808.
Canavero S (editor) (2009). Textbook of therapeutic cortical stimulation. New York: Nova Science.

Bahan bacaan terkait

Connolly, Kate. Car crash victim trapped in a coma for 23 years was conscious, The Guardian, November 23, 2009.
Hall, Alan. 'I screamed, but there was nothing to hear': Man trapped in 23-year 'coma' reveals horror of being unable to tell doctors he was conscious, Daily Mail, November 23, 2009.
Machado, Calixto, et al. A Cuban Perspective on Management of Persistent Vegetative State. MEDICC Review 2012;14(1):44–8.
Canavero S, Massa-Micon B, Cauda F, Montanaro E.Bifocal extradural cortical stimulation-induced recovery of consciousness in the permanent post-traumatic vegetative state.J Neurol. 2009 May;256(5):834-6.
Canavero S. Textbook of therapeutic cortical stimulation. New York: Nova Science, 2009

Artikel bertopik kedokteran atau medis ini adalah sebuah rintisan. Anda dapat membantu Wikipedia dengan mengembangkannya.

[1] :wikt:vegetative

[2] The Multi-Society Task Force on PVS (1994). "Medical Aspects of the Persistent Vegetative State— Second of Two Parts". New England Journal of Medicine. 330 (22): 1572–9. doi:10.1056/NEJM199406023302206. PMID 8177248.

[nejm1994-3] The Multi-Society Task Force on PVS (1994). "Medical Aspects of the Persistent Vegetative State— First of Two Parts". New England Journal of Medicine. 330 (21): 1499–1508. doi:10.1056/NEJM199405263302107. PMID 7818633.

[4] Jennett, B (1999). "Should cases of permanent vegetative state still go to court?. Britain should follow other countries and keep the courts for cases of dispute". BMJ (Clinical research ed.). 319 (7213): 796–7. PMC 1116645 . PMID 10496803.

[searchmedica.com-5] Diagnosing The Permanent Vegetative State by Ronald Cranford, MD

[6] Lamb, D. (1985). Death, Brain Death and Ethics. Albany: SUNY Press. hlm. 6. ISBN 978-0-88706-121-9.

[7] Ronald E. Cranford (1984). "Termination of Treatment in the Persistent Vegetative State". Seminars in Neurology. 4 (1): 36–44. PMID 11649666.

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