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All Journal International Journal of Public Health Science (IJPHS) International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Jurnal Anestesi Perioperatif Althea Medical Journal Global Medical and Health Communication MNJ (Malang Neurology Journal) Journal of Medicine and Health Journal of Indonesian Dental Association Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Majalah Anestesia dan Critical Care Majalah Kedokteran Neurosains Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Cermin Dunia Kedokteran Jurnal Neuroanestesi Indonesia Acta Medical and Health Sciences (AMHS) LOGIC : Jurnal Ilmu Komputer dan Pendidikan Biner : Jurnal Ilmu Komputer, Teknik dan Multimedia OKTAL : Jurnal Ilmu Komputer dan Sains AMMA : Jurnal Pengabdian Masyarakat Buletin Ilmiah Ilmu Komputer dan Multimedia (BIIKMA) Neurona Journal of Medicine and Health

Lisda Amalia

Universitas Padjadjaran

Author-ID : 1090878

Humanities Astronomy Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Control & Systems Engineering Dentistry Education Electrical & Electronics Engineering Engineering Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Transportation Other

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Gangguan Tidur pada Pasien Stroke Fase Akut Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 10, No 1 (2021)
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Stroke adalah suatu kondisi ketika seseorang terkena defisit neurologis secara tiba-tiba yang disebabkan oleh adanya gangguan pada pembuluh darah otak. Sekitar 2177% dari pasien stroke memiliki gangguan tidur yang terjadi setelah stroke. Siklus tidur diatur oleh otak dan stroke dapat menyebabkan gangguan tidur karena kelainan yang dapat terjadi pada struktur otak yang mengatur tidur. Post Stroke Sleep Disoder (PSSD) merupakan gejala tersering setelah stroke. Gangguan tidur setelah stroke meliputi Sleep Disordered Breathing (SDB), insomnia, circadian rhythm sleep disturbance, hipersomnia, parasomnia dan sleep-related movement disorder. Tidur memiliki banyak manfaat, salah satunya adalah restorasi fungsi fisik dan mental, konsolidasi memori dan meningkatkan kemampuan belajar dari seseorang baik secara motorik maupun sensorik. Penelitian lain pun menunjukkan adanya korelasi antara waktu tidur elektrografik dan fungsi kognitif dari pasien stroke pada masa pemulihan. Sebuah penelitian percobaan lain pula mengindikasikan bahwa gangguan tidur dapat meningkatkan ekspresi dari neurocan, yaitu gen yang menghambat pertumbuhan saraf. Gangguan tidur pada pasien stroke dapat menurunkan efisiensi dan efektifitas dari rehabilitasi stroke.Sleep Disorders in Acute Phase Stroke PatientsAbstractStroke is a condition when a person has a sudden neurological deficit caused by a disruption in the blood vessels of the brain. About 21-77% of stroke patients have sleep disorders that occur after a stroke. The sleep cycle is regulated by the brain and strokes can cause sleep disturbances due to abnormalities that can occur in the brain structures that regulate sleep. Post Stroke Sleep Disoder (PSSD) is the most common symptom after stroke. Sleep disorders after stroke include Sleep Disordered Breathing (SDB), insomnia, circadian rhythm sleep disturbance, hypersomnia, parasomnia and sleep-related movement disorders. Sleep has many benefits, one of which is the restoration of physical and mental functions, the consolidation of memory and improving the learning ability of a person both motorically and sensitively. Other studies have also shown a correlation between electrographic sleep time and cognitive function of stroke patients during recovery. Another experimental study also indicated that sleep disorders can increase the expression of neurocans, which are genes that inhibit nerve growth. Sleep disorders in stroke patients can reduce the efficiency and effectiveness of stroke rehabilitation

Perdarahan Gastrointestinal pada Stroke Iskemik Akut: Sebuah Tinjauan Pustaka Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 9, No 3 (2020)
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Perdarahan gastrointestinal pada stroke iskemik akut disebabkan oleh proses neuroinflamasi pada sel otak yang mengalami iskemik. Edema otak yang terjadi pada pasien stroke iskemik akut mempengaruhi hipotalamus dan batang otak. Keterlibatan nukleus vagal pada batang otak menyebabkan peningkatan stimulasi dari vagus serta berkurangnya inhibisi vagus. Proses neuroinflamasi tersebut mempengaruhi sistem saraf parasimpatis menyebabkan hiperaktivitas vagal sehingga terjadi peningkatan pelepasan gastrin yang meningkatkan produksi asam lambung. Perdarahan gastrointestinal pada pasien stroke iskemik akut mengakibatkan penghentian atau penundaan terapi antiplatelet atau antikoagulan sehingga terjadi keadaan prokoagulasi, menyebabkan lebih mudah terjadi trombosis sehingga meningkatkan risiko stroke ulang dan luaran klinis yang buruk. Beberapa penelitian perdarahan gastrointestinal pada pasien stroke iskemik akut mempunyai prognosis yang kurang baik terhadap luaran. Luaran tersebut antara lain perburukan defisit neurologis, kematian di rumah sakit, dan memperpanjang lama perawatan.Gastrointestinal Bleeding in Acute Ischemic Stroke: A Literature ReviewAbstractGastrointestinal bleeding in acute ischemic stroke is caused by the process of neuroinflamation in ischemic brain cells. Brain edema that occurs in acute ischemic stroke patients affects the hypothalamus and brainstem. Involvement of the vagal nucleus in the brainstem results in increased stimulation of the vagus and reduced inhibition of the vagus. The neuroinflamation process affects the parasympathetic nervous system causing vagal hyperactivity resulting in an increase in gastrin release which increases gastric acid production. Gastrointestinal bleeding in patients with acute ischemic stroke results in the cessation or delay of antiplatelet or anticoagulant therapy, resulting in a procoagulatory state, making thrombosis easier, thereby increasing the risk of repeated strokes and poor clinical outcomes. Several studies of gastrointestinal bleeding in patients with acute ischemic stroke have a poor prognosis for outcomes. These outcomes include worsening neurological deficits, hospital deaths, and prolonged treatment.

Karakteristik Klinis Pasien Trombosis Sinus Venosus Serebral (TSVS) di Ruang Rawat Inap Neurologi Rumah Sakit Hasan Sadikin Bandung Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 9, No 2 (2020)
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Latar Belakang dan Tujuan: Trombosis sinus venosus serebral (TSVS) merupakan penyakit akibat oklusi struktur vena intrakranial, termasuk sinus serebral, vena korteks, dan bagian proksimal vena jugularis. Keterlambatan diagnosis dan terapi dapat mengakibatkan terjadinya komplikasi seperti infark berdarah bahkan kematian.Tujuan penelitian ini adalah untuk mengetahui karakteristik klinis pasien TSVS yang diagnosisnya telah dikonfirmasi melalui pemeriksaan DSA. Metode: Penelitian ini bersifat deskriptif observasional retrospektif. Pada pasien yang telah didiagnosis TSVS di Bagian Neurologi Rumah Sakit Hasan Sadikin Bandung periode Juni 2015 sampai November 2017.Hasil: Terdapat 33 subjek dengan rentang usia 40-49 tahun (24,2%) dan mayoritas adalah perempuan sebanyak 22 orang (66,7%). Faktor resiko terbanyak adalah infeksi 8 orang (24,2%), dan kondisi protrombotik sebanyak 6 orang (18,2%). Gejala klinis terbanyak adalah nyeri kepala yaitu 27 orang (81,8%). Lokasi sinus yang tersering mengalami trombosis adalah sinus transversus pada 28 orang dengan gejala mayoritas nyeri kepala. Kadar D-Dimer ditemukan meningkat dengan rata-rata 1,21 mg/L.Simpulan: Pasien TSVS terjadi pada perempuan dengan rentang usia dekade pertengahan dan faktor resiko terbanyak adalah infeksi. Nyeri kepala merupakan gejala paling sering. Lokasi trombosis mayoritas terjadi pada sinus transversus dan ditemukan peningkatan D-Dimer.Clinical Characteristics of Cerebral Venous Sinus Thrombosis (CVST) Patients in Neurology Ward Hasan Sadikin General Hospital BandungAbstractBackground and Objective: CVST is an entity caused by intracranial vein, including cerebral sinuses, cortical vein and proximal part of the jugular vein. A delay in diagnosing and treating can result in brain infarct with hemorrhagic transformation, even death. The goal of this study is to learn the clinical characteristics of patients with CVST that had been confirmed by DSA.Method: This was a retrospective observational descriptive study and subjects were hospitalized patients which had been diagnosed CVST in Neurology ward Hasan Sadikin General Hospital from June 2015 to November 2017.Results: there was 33 subjects with most (22 patient/66.7%) being women between 40-49 years old. In this study the most frequently found risk factor was infection in 8 subjects (24.2%), prothrombotic conditions in 6 subjects (18.2%). The clinical manifestations were mainly headache in 27 subjects (81,8%). The sinus most often involved was the transverse sinus (28 subjects) with the clinical manifestation being headache. D-dimer levels were also increased with mean 1.21 mg/dl.Conclusion: CVST patients are mostly in women at the midle age of decade, with infection being the most frequent risk. Headache was the most frequent clinical manifestation. Location of thrombosis were more often found on the transverse sinus and D-Dimer level was increased.

Peran Eritropoietin pada Stroke Iskemik Akut Amalia, Lisda; Saputra, Gilang Nispu
Jurnal Neuroanestesi Indonesia Vol 9, No 2 (2020)
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Stroke iskemik merupakan salah satu penyebab stroke tersering, disebabkan oleh oklusi pembuluh darah serebral dan penyebab kematian ketiga. Iskemik otak akan menghasilkan penghasilan mediator inflamasi yang dapat berpartisipasi dalam jejas iskemik di otak. Saat awitan stroke iskemik terjadi, area otak yang diperdarahi oleh pembuluh darah akan kekurangan oksigen dan nutrisi sehingga sel otak terutama neuron berada dalam risiko, neuron ini masih dapat berfungsi yang dikenal sebagai penumbra. Hipoksia jaringan dan iskemik serebral mengaktivasi HIF-1?, yang kemudian mengaktivasi transkripsi gen eritropoietin (EPO) dan Vascular Endothelial Growth Factor (VEGF). Eritropoietin (EPO) merupakan peptida yang juga memiliki efek nonhematopoiesis yaitu berperan mendorong neuroproteksi. Eritropoietin (EPO) dikeluarkan dalam hitungan menit dari proses iskemik dan mencapai puncak dalam 24 jam dari awitan stroke iskemik. Efek neuroproteksi dari EPO yaitu sebagai anti apoptosis, anti oksidan, anti inflamasi, anti eksitoksisitas, neurogenesis, angiogenesis dan neurotropik. Dengan kata lain bahwa EPO dapat mengurangi derajat keparahan akibat oklusi pembuluh darah otak.Role of Eritropoietin in Acute Ischemic StrokeAbstractIschemic stroke is one of the most common causes of stroke, caused by cerebral vascular occlusion and the third cause of death. . Ischemic brain will generate income of inflammatory mediators who can participate in ischemic lesions in the brain. When the recitation of an ischemic stroke occurs, areas of the brain that are obscurated by blood vessels will lack oxygen and nutrients so that brain cells, especially neurons, are at risk, these neurons can still function known as penumbra. Tissue hypoxia and cerebral ischemic activate HIF-1?, which then activates the transcription of the Eritropietin (EPO) and Vascular Endothelial Growth Factor (VEGF) genes. Eritropoietin (EPO) is a peptide that also has the effect of non-hematopoiesis which is responsible for encouraging neuroprotection. Eritropietin (EPO) is issued in minutes of an ischemic process and reaches its peak within 24 hours of the onset ischemic stroke. The neuroprotection effect of EPO is as anti-apoptosis, anti-oxidant, anti-inflammatory, anti-excitation, neurogenesis, angiogenesis and neurotropic. In other words, EPO can reduce the severity due to occlusion of brain blood vessels.

Periodontal Health Status and Level of Periodontal Treatment Needs in Stroke Patients at Hasan Sadikin Hospital Bandung Sukmawati, Rani; Sari, Kartika Indah; Susanto, Agus; Amalia, Lisda
Journal of Indonesian Dental Association Vol 3 No 2 (2020): October
Publisher : Indonesian Dental Association

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Introduction: A stroke is any form of brain disorder or central nervous system damage caused by altered blood flow to the brain that impairs motor and cognitive function. Impaired motor and cognitive function restrict oral hygiene, so these patients are vulnerable to dental health problems, such as periodontal disease. They often require help from family members to assist them with oral care. Objectives: The aim of this study was to describe the condition of periodontal tissue and the periodontal treatment needs of stroke patients. Method: This research is a descriptive study using a cross-sectional format. It was conducted at Hasan Sadikin Hospital Bandung with a sample of 30 stroke patients. An examination of periodontal status and periodontal treatment needs was performed using an index from the World Health Organization, the Community Periodontal Index of Treatment Needs (CPITN). Results: None of the patients had healthy periodontal tissue status (score 0), gingival bleeding during or after probing (score 1), or a periodontal pocket ≥ 6 mm (score 4). Nine patients (30%) had supragingival or subgingival calculus (score 2), and 21 patients (70%) had 4–5 mm periodontal pockets (score 3). Conclusion: Most stroke patients at Hasan Sadikin Hospital Bandung had a pocket depth of 4–5 mm, and their periodontal health status indicated a need for scaling, root planing, removal of plaque retentive factors, and oral hygiene instructions.

Perbandingan Osmolaritas, Kadar Natrium dan Klorida Plasma setelah Pemberian NaClRL (3:1) dengan Ringerfundin pada Pasien Tumor Otak Martinus, Fardian; Fuadi, Iwan; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 3, No 1 (2014)
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Latar Belakang dan Tujuan : Kristaloid NaCl 0,9% merupakan cairan dasar yang sering digunakan pada perioperatif pasien tumor otak, namun berpotensi menyebabkan asidosis hiperkloremia sehingga dikombinasikan dengan Ringer Laktat. Ringerfundin, kristaloid yang komposisi elektrolitnya hampir ideal, namun belum banyak penelitiannya dalam kasus bedah saraf. Tujuan penelitian adalah membandingkan pemberian cairan kombinasi NaCl 0,9%: RL (3:1) dengan cairan Ringerfundin pada pasien tumor otak untuk melihat osmolaritas, natrium dan klorida plasma. Subjek dan Metode: Penelitian Randomized Controlled Trial (RCT) pada 36 pasien tumor otak yang menjalani kraniotomi, di Rumah Sakit Hasan Sadikin. Sampel dibagi menjadi kelompok NaCl 0,9%:RL (3:1) dan kelompok Ringerfundin. Dilakukan pemeriksaan natrium, klorida plasma dan osmolaritas plasma sebelum dan setelah pemberian cairan sebanyak 1 liter. Data penelitian dianalisis dengan uji t.Hasil: Analisis statistik menunjukkan tidak terdapat perbedaan yang bermakna kedua kelompok setelah pemberian cairan dalam perhitungan osmolaritas plasma 291,42 vs 290,21 (p=0,63) dan natrium plasma 141,28 vs 141,06 (p=0,82). Terdapat perbedaan yang bermakna kadar klorida kelompok NaCl 0,9%: RL dibandingkan dengan kelompok ringerfundin 106,33 vs 104,39 (p=0,02). Simpulan: Ringerfundin dapat menjadi cairan alternatif dari NaCl 0,9%: RL dengan tidak menyebabkan perubahan pada osmolaritas, peningkatan kadar natrium dan kadar klorida plasma.The Comparison of Osmolarity, Plasma Natrium and Chloride Level After Administering NaCI-RL (3:1) and Ringerfundin in Brain Tumor Patients Undergoing CraniotomyBackground and Objective: One of most commonly used crystalloid for perioperative fluid administration in patients with brain tumor is NaCl 0,9%, and because it has potential to cause hyperchloremic acidosis, its administration usually combined with Ringer Lactate. Ringerfundin is a crystalloid solution which contains electrolyte composition that is considered as the most ideal solution, but has not been frequently used in neurosurgery procedure. The aim of this study is to compare the plasma osmolarity, sodium and chloride levels in brain tumor patient after the administration NaCl 0,9% combined with: RL solution in 3:1 ratio and after ringerfundin administration.Subject and Method: Thirty six patients underwent craniotomy tumor removal were assigned randomly to receive NaCl 0,9%: RL (3:1) or ringerfundin solutions. Sodium and chloride plasma level and calculated plasma osmolarity were recorded at baseline and after one liter of fluid adminisitration. Data were analyzed with by using t-test analysis. Result: Statistic analysis showed no significant differences between the two groups in calculated plasma osmolarity (291,42 vs 290,21; (p=0,63) and sodium plasma level (141,28 vs 141,06; (p=0,82). A significant increased in chloride plasma level after one liter of fluid administration was observed in NaCl 0,9%: RL group compared to ringerfundin group (106,33 vs 104,39 respectively; (p=0,02).Conclusion: Ringerfundin is safe and can be use as an alternative fluid aside the most commonly used fluid combination using NaCl 0,9% and RL solutions, without causing changes in plasma osmolarity, and sodium or chloride plasma level.

Perbandingan Mini Mental State Examination (MMSE) dan Clock Drawing Test (CDT) untuk Mendeteksi Disfungsi Kognitif pada Cedera Otak Traumatik Ringan dan Sedang Oktivia, Wenny; Fuadi, Iwan
Jurnal Neuroanestesi Indonesia Vol 8, No 2 (2019)
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Latar Belakang dan Tujuan: Disfungsi kognitif sering terjadi pada pasien cedera otak traumatik (COT). Gangguan neuropsikologik yang disebabkan oleh cedera otak traumatik ringan dan sedang berupa penurunan kecepatan memproses informasi, gangguan perhatian, orientasi, dan fungsi eksekutif. Pemeriksaan disfungsi kognitif yang sering digunakan adalah Mini Mental State Examination (MMSE). Saat ini sedang dicari pemeriksaan lain yang lebih mudah dilakukan dan memiliki sensitifitas dan spesifisitas yang lebih baik, yaitu dengan Clock Drawing Test (CDT). Penelitian ini bertujuan membandingkan MMSE dan CDT dalam mendeteksi disfungsi kognitif pada COT ringan dan sedang. Subjek dan Metode: Penelitian menggunakan observasi analitik cross sectional, dilakukan di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan Januari hingga April 2018. Pasien dibagi menjadi kelompok COT ringan (n=16) dan sedang (n=16) yang masing-masing dilakukan pemeriksaan MMSE dan CDT. Hasil: Dengan nilai cut-off MMSE 26,5 didapatkan sensitivitas 93,8% dan nilai spesifisitas 81,3%, sedangkan menggunakan nilai cut-off CDT 2,5 didapatkan sensitifitas dan spesifisitas CDT 100%. Simpulan: CDT memiliki sensitivitas dan spesifisitas yang lebih baik untuk mendeteksi disfungsi kognitif pada COT ringan dan sedang.Comparison of Mini Mental State Examination (MMSE) and Clock Drawing Test (CDT) on Detecting Cognitive Dysfunction on Mild and Moderate Traumatic Brain InjuryAbstractBackground and Objective: Cognitive dysfunction often found in Traumatic Brain Injury (TBI). TBI can triggers neurophysicological, such as slower information processing, attention deficit, orientation disturbance, and executive function. There are methods to evaluate cognitive dysfunction, but none are showing 100% sensitivity and specificity. The frequently used method is Mini Mental State Examination (MMSE). Currently, other examinations are being sought that are easier to do and have better sensitivity and specificity, namely the Clock Drawing Test (CDT). This study is aimed to compare MMSE and CDT to detect cognitive dysfunction in Mild and Moderate TBI. Subject and Method: This study is using analytical observation and cross-sectional study design, it was held in Hasan Sadikin Hospital Bandung throughout January 2017 to April 2018. Subjects are divided into Mild TBI group (n=16) and Moderate TBI group (n=16), both groups were given MMSE and CDT. Result: Using cut-off point 26,5 for MMSE the sensitivity and specificity are 93.8% and 81.3%, while CDT achieved 100% sensitivity and specificity. Conclusion: CDT has a better sensitivity and specificity on detecting cognitive dysfunction in Mild and Moderate TBI.

Penanganan Anestesi pada Ventriculo Peritoneal Shunt Cito e.c Hidrocephalus dengan Perdarahan Intraventricular Novitasari, Dian; Fuadi, Iwan; Saleh, Siti Chasnak; Wargahadibrata, A. Hmendra
Jurnal Neuroanestesi Indonesia Vol 6, No 3 (2017)
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Perdarahan intraventrikular akibat perluasan perdarahan subarahnoid ke ruang intraventrikel atau akibat perdarahan intraserebral menyebabkan hidrosefalus merupakan prediktor independent prognosis yang buruk pada stroke hemoragik. Kondisi hidrosefalus dengan perdarahan intraventrikular membutuhkan Ventriculo Peritoneal (VP) Shunt segera untuk menghindari defisit neurologis permanen bahkan kematian. Pasien seorang laki-laki dewasa (56 tahun) dengan bb 75 kg, dengan hipertensi kronis dan penurunan kesadaran disertai hipertensi intrakranial dengan CT Scan menunjukkan adanya hidrosefalus disertai perdarahan intraventrikular luas. Dilakukan anestesi dengan kombinasi anestesia intravena menggunakan propofol, dexmedetomidine - sevofluran 1 MAC dapat menjadi pilihan dalam operasi bedah saraf. Tindakan VP Shunt segera pada pasien ini merupakan tindakan yang bersifat life saving dengan managemen anestesi yang baik memberikan outcome yang baik.Anesthesia Management for Emergency Ventriculo Peritoneal Shunt ec Hydrocephalus with Intraventricular HemorrhageIntraventricular hemorrhage due to the expansion of subarachnoid hemorrhage due to space intraventricular or intracerebral hemorrhage cause hydrocephalus is an independent predictor of poor prognosis in hemorrhagic stroke. Hydrocephalus condition with intraventricular hemorrhage requiring ventriculo peritoneal (VP) shunt immediately to avoid permanent neurological deficits and even death. In this case report will discuss the management of anaesthesia in emergency VP Shunt for a patient with chronic hypertension, history of loss of consciousness accompanied by intracranial hypertension and CT scan result showed the existence of intra-ventricular hemorrhage with hydrocephalus wide. The combination of intravenous anesthesia using propofol, dexmedetomidine - 1 MAC sevoflurane may be an option in the operation of neurosurgery. VP Shunt immediate action in these patients is an act that is life saving with good anesthetic management provides a good outcome.

Deep Vein Thrombosis (DVT) Pasca Cedera Otak Traumatik Berat Martaria, Nency; Fuadi, Iwan; Sudadi, Sudadi
Jurnal Neuroanestesi Indonesia Vol 8, No 3 (2019)
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Cedera otak traumatik(COT) adalah penyebab utama kematian dan disabilitas. Deep vein thrombosis (DVT) adalah salah satu risiko tinggi dari COT. Faktor risiko DVT lain yang umum ditemukan pada pasien COTadalah paralisis, imobilisasi, dan cedera ortopedi. Deep vein thrombosis diduga terkait gangguan koagulasi yang sering ditemukan pada COT, terutama pada COT berat. Deep vein thrombosis dapat menyebabkan pulmonary embolism (PE) yang merupakan salah satu penyebab kematian lambat terbanyak pada pasien trauma. Diagnosis DVT didapatkan melalui stratifikasi risiko, pemeriksaan fisik, dan pemeriksaan penunjang yang mencakup pemeriksaan d-dimer, ultrasonografi, dan penunjang lain seperti spiral computed tomography venography. Tata laksana DVT pada pasien COT mencakup pemberian antikoagulan intravena yang dilanjutkan oral jangka panjang,stoking kompresi, dan pemasangan vena cava filter (VCF). Pada pasien COT, adanya risiko perdarahan intrakranial umumnya menimbulkan keraguan pada klinisi terkait inisiasi profilaksis farmakologis dengan antikoagulan. Profilaksis nonfarmakologis mencakup penggunaan graduated compression stocking (GCS), alat kompresi pneumatik (pneumatic compression devices/PCD), A-V foot pump, dan vena cava filter (VCF). Beberapa studi terkini menyarankan pemasangan PCD pada semua pasien COT pada awal perawatan selama tidak ditemukan kontraindikasi. Pemeriksaan CT selanjutnya dilakukan setelah 24 jam. Penemuan hasil yang stabil pada CT, profilaksis farmakologis dapat dimulai dalam 24-48 jam setelah CT. Selama pemberian antikoagulan, CT serial dapat dilakukan untuk memantau progresi perdarahan.Deep Vein Thrombosis (DVT) after Severe Traumatic Brain InjuryAbstractTraumatic brain injury (TBI) is a risk factor for deep vein thrombosis (DVT). Beside the common risk factors of DVT among TBI patients, this is associated with coagulopathycommonly foundin TBI, especially in severe TBI.Diagnosis and treatment of DVT are also crucial to prevent mortality. Deep vein thrombosis could be diagnosed through risk stratification, physical examination, and d-dimer as well as ultrasonography examination. Treatment includes intravena anticoagulant continue with longterm oral, stocking compression and the use of vein cava filter (VCF). Deep vein thrombosis could cause pulmonary embolism (PE), a common cause of late mortality in trauma patients. Deep vein thrombosis could be prevented pharmacologically (with anticoagulant) and nonpharmacologically. However, in TBI patients, the risk of intracranial hemorrhage usually considered an initiation of pharmacological prophylaxis. Nonpharmacological prophylaxisincludes graduated compression stocking (GCS), pneumatic compression devices (PCD), A-V foot pump, and vena cava filter (VCF). Latest studes suggest the use of PCD for all TBI patients without contraindication since administration. Computed tomography should be performed within 24 hours and if the resultis stable, pharmacological prophylaxis should be initiated within 24-48 hours.

Penatalaksanaan Anestesi pada Pasien dengan Sindroma Apert yang Dilakukan Suturektomi Rachman, Iwan Abdul; Fuadi, Iwan; Surahman, Eri
Jurnal Neuroanestesi Indonesia Vol 2, No 2 (2013)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Sindroma Apert adalah suatu gangguan genetik yang ditandai dengan penggabungan tulang yang terlalu dini (kraniosinostosis). Penggabungan dini tersebut menghambat pertumbuhan normal tulang dan mempengaruhi pertumbuhan bentuk kepala dan wajah. Penggabungan dini tulang kepala dapat mempengaruhi perkembangan otak bahkan menyebabkan peningkatan tekanan intrakranial, dan pada sindroma Apert juga didapatkan penggabungan beberapa jari tangan dan kaki (sindaktili). Seorang anak berusia 2 tahun dengan sindroma Apert. Tanda klinis peningkatan tekanan intrakranial belum didapatkan sehingga operasi dijadwalkan terencana dan pasien dirawat terlebih dahulu di ruangan. Kemungkinan kesulitan untuk intubasi dengan laringoskopi diantisipasi dengan persiapan intubasi menggunakan optik fiber dan trakeostomi. Pasien diberikan premedikasi midazolam 0,5 mg intravena pada saat pasien akan dibawa ke kamar operasi. Dilakukan anestesi umum, induksi menggunakan propofol 30 mg, fentanil 30 ?g diberikan 3 menit sebelum intubasi. Fasilitas intubasi dengan vekuronium 2 mg, pemeliharaan anestesi dengan N2O/O2 dan Sevofluran. Vekuronium diberikan 1 mg /jam. Ventilasi kendali menggunakan ETT no. 5,0. Operasi berlangsung selama 6 jam dengan posisi pasien terlentang. Hemodinamik selama operasi relatif stabil, tekanan darah sistolik berkisar 90-110 mmHg, tekanan darah diastolik 50-70 mmHg, laju nadi (HR) 87-110 x/mnt, SaO2 99-100 %. Setelah operasi berakhir pasien bernafas spontan adekuat dan dilakukan ekstubasi di kamar operasi. Pasca operasi pasien di rawat di PICU hingga hari ke-4 pasien dipindahkan ke ruangan. Gangguan penggabungan tulang kepala yang terlalu dini dapat menyebabkan gangguan pertumbuhan bentuk kepala, otak dan gangguan pendengaran dan penglihatan. Selain itu juga dapat menyebabkan terjadinya peningkatan tekanan intrakranial. Koreksi segera dengan melakukan suturektomi dan dekompresi dapat mencegah kemungkinan-kemungkinan tersebut.Anaesthetic management of patient with Apert syndrome which undergo suturectomy Apert syndrome is a genetic disorder characterized by the premature fusion of certain skull bones (craniosynostosis). This early fusion prevents the skull from growing normally and affects the shape of the head and face. Early fusion of the skull bones also affects the development of the brain and even can increased the intracranial pressure. In apert syndrome there was also fusion of fingers and toes (syndactyly). A 2 years old child with Apert syndrome which undergo suturectomy and decompression. The clinical signs of raised intracranial pressure in this patient has not been obtained yet so the surgery was done as scheduled . Difficulties to perform intubation with direct laryngoscopy were anticipated through the use of fiber optic and preparation of tracheostomy. Patient has been given premedication using midazolam 0,5 mg given intravenously before his admission to the operating room. The surgery is performed with general anesthesia using propofol 30 mg then fentanyl 30mcg, 3 minutes before intubation. Vecuronium 2mg was given to facilitates intubation. Maintenance of anesthesia with Nitroons/O2 sevoflurane and Vecuronium 1mg/hour. Ventilation was controlled by using ETT no 5.0. Patient was in supine position, and it last for 6 hours. There was relatively stable hemodynamics, systolic blood pressure range 90-110 mmHg, diastolic blood pressure 50-70 mmHg, pulse rate 87-110x/minutes, SaO2 99-100%. After the operation, there was adequate spontaneous breathing so extubation was performed in the operating room, then he was referred to PICU. On day 4 patient was moved to the room. Premature fusion of skull bones will cause growth disorders of the head, brain, and hearing and vision impairment. It also can cause increased intracranial pressure. Immediate correction by suturectomy and decompression can prevent this possibility.

Co-Authors - Elvidiansyah - Elvidiansyah A Himendra Wargahadibrata A Himendra Wargahadibrata A. Muthalib Nawawi A.A. Ketut Agung Cahyawan W Abdul Muthalib Nawawi Abdul Muthalib Nawawi Abdul rachman, Iwan Abdul Rahman Adnin Nugroho Adriana Damayanti Afdi Arahim Putra Agnes Rengga Indrati Agus Susanto Agusti Setiabudi Pramata Ahmad Doni ahmad doni Ahmad Rizal Ahmad Rizal Ahmad Rizal ahmad rizal Ahmad Rizal Ganiem Ahmad Rizal Ganiem, Ahmad Rizal Aih Cahyani Aisyah Ummu Fahma Al Rasyid Amanda Diannisa Azzahra Amany Khansa Amaylia Oehadian Aminuyati Anam Ong Anam Ong Ananda Pratama Kesumaningtyas Gunawan Andi Basuki Prima Birawa Andi Basuki Prima Birawa Andi Basuki Prima Birawa Andre Aditya Andre Tanuwijaya, Andre Andy Hutariyus Anindyta Murfia Khairunnisa Ardhana Risworo Anom Yuswono Ardhana Risworo Anom Yuswono Ardi Zulfariansyah Ardi Zulfariansyah Ardi Zulfariansyah Ardiana Ari Saptadi Ari Saptadi Aries Saifudin Ariestian, Erick Army Zaka Anwary, Army Zaka Arna Fransisca Arsy Felisita Dausawati Arsy Felisita Dausawati Arviana Adamantina Putri Asep Nugraha Hermawan Asep Nugraha Hermawan Asep Nugraha Hermawan Asyer Asyer Ayu, Auliya Putri Badriyah, Nur’aini Jamilatul Berliana, Sobaryati Biben, Vitriana Bisri, Tatang https://scholar.google.co.id/citations?u Bramantyo Pamugar Calista, Chandra Cep Juli Chandra Calista Citra Windani Mambang Sari Dedi Fitri Yadi Defri Aryu Dinata Defri Aryu Dinata, Defri Aryu Dessy Sutoyo Dewi Ramadani Dewi Ramadani Dewi Yulianti Bisri Dian Novitasari Doddy Tavianto Dzulfikar D. L. Hakim Eka Damayanti Eko Nofiyanto Eppy Buchori Eppy Buchori Aristiady Eri Surahman Eri Surahman Erick Ariestian Erwin Pradian Eva Srigita Tari Ezra Oktaliansah Fadila Arsanti Fahma, Aisyah Ummu Fauzan Musyaffa Fifi Veronica Firdaus, Riyadh Fithrah, Bona Akhmad Fithrah, Bona Akhmad Fitri Sepviyanti Sumardi Fitri Yanti Gaga Irawan Nugraha Galuh Saputri Ginna Megawati Glenn Mark Togu Gloria Kartika Gunadharma, Suryani Guntur Darmawan Hamzah Hamzah Hanna Goenawan Hanna Goenawan Hansen Wangsa Herman Haqun Baitika Harahap, M Sofyan Harry Galuh Nugraha Hartiah Haroen Hermawan, Asep Nugraha Hidayat, Dede A Hidayat, Faqih Hidayat, Shaffana Hilman Hilman Hunter D. Nainggolan Hunter D. Nainggolan Ida Parwati Ike Sri Redjeki Ike Sri Redjeki Indra Wijaya Indriasari Indriasari Islami, Aditya Iwan Abdul Rachman Jerico Franciscus Pardosi Jimmy Setiadinata Jimmy Setiadinata, Jimmy Jonathan Jeremi Siagian Kartapraja, Roni D. Kartika, Gloria Khairunnisa, Shafa Ayu Khofifah Nurfaisah Lailiyya, Nushrotul Laniyati Hamijoyo, Laniyati Lee Shok Chen Lee Shok Chen, Lee Shok Leni Lismayanti Liunardo Bintang Pratama Lukman Hidayat Lulu Eva Rakhmilla, Lulu Eva M Andy Prihartono M. Erias Erlangga M. Erias Erlangga, M. Erias Maharani, Nurmala Dewi Mariko Gunadi Mariko Gunadi Marina A. Moeliono Marina A. Moeliono, Marina A. Martaria, Nency Martinus, Fardian Martinus, Fardian Maulana Muhammad Maulana Muhammad, Maulana Mayasari, Ferra Mayasari, Ferra Millata Azma Basmala Muhammad Adjie Pratama Muhammad Mustofa Ramadhan Nadya, Siti Fairuz Nandina Oktavia Nani Kurniani Nesyia Tara Restikasari Neti Juniarti Nur Atiik Nurmin, Rahmawati Nurohman Nushrotul Lailiyya Nushrotul Lailiyya Nushrotul Lailiyya Dahlan Oktivia, Wenny Ong, Paulus Anam Pamugar, Bramantyo Pandji Irani Fianza Paranita Utama Paulus Anam Ong Paulus Anam Ong Paulus Anam Ong Pison, Osmond Muvtilof Pramodana, Bintang Prihatno, M. Mukhlis Rudi Putri, Dini Handayani R, Tubagus Yuli R, Tubagus Yuli Radian Ahmad Halimi Rahmadsyah, Teuku Rahmatisa, Dimas Rahordjo, Sri Ramdan Panigoro Reihan Achmad Reza Reza W. Sudjud Ria Bandiara Richard Pahala Sitorus Rico Defryantho,* Lisda Amalia,* Ahmad Rizal,** Suryani Gunadharma,* Siti Aminah,* Nushrotul Lailiyya* Rini Rustini Rita Arsika Fauziah Riyadh Firdaus Rizkia, Fildza Intan Rizky Gimnastiar Roni D. Kartapraja Rudi Kurniadi Kadarsah Ruli Herman Sitanggang S, Achmad Afif Saleh, Siti Chasnak Saleh, Siti Chasnak Saprudin Saprudin Saputra, Gilang Nispu Sari, Kartika Indah Setiawan Setiawan Shenny Dianathasari Santoso Sidabutar, Berliana Sitanggang, Ruli H. Siti Aminah Siti Aminah Siti Aminah Siti Aminah Siti Aminah Siti Aminah Sobana Siti Nur Fatimah Sitorus, Richard Pahala Siuliyanty, Siuliyanty Sobaryati Sobaryati Sobaryati Sobaryati Sobaryati, Sobaryati Sofiati Dian Sri Rahardjo Sri Rahardjo Sudadi Sudadi Sukmawati, Rani Suryadi Suryadi Suryani Gunadharma Suryani Gunadharma Suryani Gunadharma Sutoyo, Dessy Suwarman, S Suwarman, S Syifa, Nadia Syifa, Nadia Tantarto, Tamara Tatang Bisri Tatang Bisri Theresia C. Sipahutar Theresia C. Sipahutar Theresia Monica Rahardjo Thomas Thomas Tiara Pramaesya Tiene Rostini, Tiene Tinni T. Maskoen Tinni T. Maskoen Tinni T. Maskoen Trislawati, Cristina Trully Deti Rose Sitorus Uni Gamayani Uni Gamayani Uni Gamayani Uni Gamayani Uni Gamayani Uni Gamayani Uni Gamayani Uni Gamayani Uni Gamayani, Uni Vania Angeline Bachtiar Verolia Yunita Putri Wandira, Rega Dwi Wardhani, Ildzamar Haifa Wardoyo, Chandra Calista Wargahadibrata, A. Hmendra Wargahadibrata, A. Hmendra Widiastuti, Monika - Wildan Firdaus Wirayuga Rizkia Suwahyo Yovita Stevina Yunita Susanto Putri Yunita Susanto Putri Yusuf Wibisono Yusuf Wibisono Zamzami, Nyiemas Moya Zamzami, Nyiemas Moya

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