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All Journal International Journal of Health, Engineering and Technology
Delta Iswara
An Nimah General Hospital
Agriculture, Biological Sciences & Forestry Chemical Engineering, Chemistry & Bioengineering Dentistry Engineering Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Mechanical Engineering Medicine & Pharmacology Nursing Public Health Veterinary

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Near-Fatal Asthma With Severe Hypercapnic Respiratory Failure Requiring Mechanical Ventilation In A Resource-Limited Setting: A Case Report Sinta Triagustina; Delta Iswara; Anggita Dian Karera; Rois Hasyim; Rachmad Aji Saksana
International Journal of Health Engineering and Technology Vol. 5 No. 1 (2026): IJHET MAY 2026
Publisher : CV. AFDIFAL MAJU BERKAH

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55227/ijhet.v5i1.734

Abstract

Near-fatal asthma (NFA) is a life-threatening manifestation of acute severe asthma characterized by hypercapnia, respiratory acidosis, altered consciousness, and the need for invasive mechanical ventilation. Early recognition and timely airway stabilization are essential to prevent respiratory arrest and mortality, particularly in resource-limited settings. A 41-year-old woman with a history of asthma was brought to the emergency department with decreased consciousness and severe respiratory distress. On arrival, her Glasgow Coma Scale score was 5, respiratory rate was 35 breaths per minute, and oxygen saturation was 46% on room air. Arterial blood gas analysis demonstrated life-threatening hypercapnic respiratory failure (pH 6.954; PaCO₂ 95.4 mmHg; P/F ratio 87). Due to worsening respiratory failure and decreased level of consciousness, the patient underwent immediate endotracheal intubation and invasive mechanical ventilation and was admitted to the intensive care unit. She received systemic corticosteroids, repeated bronchodilator therapy, aminophylline infusion, and broad-spectrum antibiotics. Lung-protective ventilatory strategies with prolonged expiratory time were applied. The patient improved rapidly and was successfully extubated on the second day of mechanical ventilation, with subsequent discharge in stable condition. Appropriate ventilatory strategies combined with guideline-based pharmacological therapy are essential to improve outcomes in patients with near-fatal asthma presenting with severe hypercapnic respiratory failure, even in resource-limited settings.
Conservative Treatment With Mannitol In A Young Adult With Intracerebral Hemorrhage Resulting In Complete Neurological Recovery: A Case Report Setiawan Dwi Prabandanu; Delta Iswara; Hermanto Hermanto
International Journal of Health Engineering and Technology Vol. 5 No. 2 (2026): Vol 5. No. 2 JULY 2026
Publisher : CV. AFDIFAL MAJU BERKAH

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55227/ijhet.v5i2.1072

Abstract

Intracerebral hemorrhage (ICH) resulting from arteriovenous malformation (AVM) rupture is a neurological emergency associated with increased intracranial pressure, cerebral edema, and a high risk of morbidity and mortality. Although surgical intervention is the standard treatment for selected patients, conservative management may be considered in clinically stable individuals. The role of mannitol in improving outcomes in young patients with AVM-related ICH remains incompletely understood. We report the case of a 22-year-old man who presented with sudden-onset severe headache accompanied by nausea and vomiting. Brain computed tomography revealed a left parieto-occipital intracerebral hemorrhage with intraventricular extension, while subsequent imaging confirmed a ruptured AVM as the underlying cause. The patient was hemodynamically stable and exhibited no significant focal neurological deficits. Conservative treatment consisting of intravenous mannitol, antihypertensive therapy, analgesics, and supportive care was initiated with close neurological monitoring. During hospitalization, the patient's clinical condition progressively improved, with resolution of headache, nausea, and vomiting, accompanied by recovery of consciousness. He was discharged without residual neurological deficits. This case highlights that conservative management with mannitol may achieve favorable neurological outcomes in carefully selected young adults with AVM-related intracerebral hemorrhage. Early diagnosis, appropriate intracranial pressure control, and close clinical monitoring are essential for optimizing patient recovery. Further studies are needed to establish the role of conservative therapy in similar clinical settings.
Co-Authors Anggita Dian Karera Hermanto Hermanto Rachmad Aji Saksana Rois Hasyim Setiawan Dwi Prabandanu Sinta Triagustina